Most states that require insurance (car insurance, say) also have Insurance Boards that regulate rates.
But technically, I suppose you could say that in a free market mandatory insurance should have no effect on rates. Companies will still compete over price, and those who are the worst risks will always pay higher rates than those who aren't.
Unfortunately, I suspect that most people who don't currently have health insurance are probably worse risks than those who do, so they would end up paying the most.
President Bush, of all people, recently floated a proposal that's shocking in its fairness: Make employees pay taxes on employer-funded insurance premiums, and let everybody deduct out-of-pocket expenses from their taxable income. This would be of great benefit to those who don't get health benefits from an employer, and remove what amounts to a federal subsidy for insurance companies.
Rarely does one see something proposed that manages to satisfy free-market principles and be radically redistributionist at the same time. Needless to say it was dead on arrival in Congress.
There's a difference between health-insurance, and health-care.
Using your car analogy insurance," it's just that. You insure your car in case anything happens. You don't have any type of policy to take your car in for preventive maintenance, check-up, or repairs.
You car insurance has deductables, coverage limits, liability coverage, etc., while health-insurance has similar types of coverage, there are also limits to how much it will pay, and for what. That my friend IS NOT health-care.
Most people that I know personally don't have either if they're self-employed because they
can't afford it. They take a gamble everyday of getting into an accident and having to go to the county hospital, where after health-care has been provided are now strapped with huge bills, and often times either have their credit ruined because they can't afford to pay, or end up having to file for bankruptcy.
I know some people who ended up having to do just that because the insurance premiums that they had been paying every month, wouldn't pay because they didn't file some form correctly. The would have been better off taking that premium payment and putting it into a savings account. At least they could have used that money to pay down their medical debt.
As a self-employed single man, I cannot deduct my medical expenses from my income tax each year. But if I was married I could. That's bullshit. The National Association of the Self-Employed (NASE) has been working on getting that changed, but I'm not aware if they've had any luck.
Here in the real world, if the Feds require the employer to pay taxes on insurance premiums, the employer will just drop the insurance. That's how small businesses work. If they can't afford it, they won't offer it. Which is why I'm technically "self-employed."
I have an employer, and they take out taxes for my wages, but I had to join a group like NASE so that we could pool together for health-care benefits. I had to drop my health-care benefits because they eventually exceeded the cost of my truck payment and my truck insurance combined each month. All within the span of about 8 months.
Now I have "health-insurance." They assured me when I signed on that my premiums would never go up. Guess what? With no claims on that insurance I received a letter the other day informing me "that due to costs" they were going up on my monthly premiums by more than $40.00 which makes my insurance payment $80.00 MORE per month than the "full-coverage" insurance that I'm paying on my truck.
So my monthly insurance premiums are now running neck and neck with my monthly automotive expenses, and right behind my mortgage payments.
I'm lucky I don't have kids to feed and to provide for, because I couldn't afford to do so. Something would have to be cut from my budget somewhere, and most likely it would be my "health-insurance." I would have to take that risk, that gamble that I wouldn't get into an accident.
Mandatory Health Insurance, what a scam! Texas has the highest insurance rates in the nation, and they're "regulated" by the state. Each year the insurance companies want a rate increase, and each year the Republican appointed Insurance Board gives them whatever they want, without once having to justify why our rates are higher than Arkansas, Oklahoma, New Mexico, or Louisiana.
Scrap the system and start all from scratch is what I say. It's just a big piled on over/under regulated mess; not cost controls, no caps, CEO's getting richer, and more and more people deciding between eating or their medicines.
It's broken, and it needs to be replaced. Not repaired, not overhauled, but replaced. Something brand new needs to take its place.
Honestly I'm not expecting much from either party candidate short of perhaps a
"band-aid," an
"aspirin" and
"call in 15 years so we can see if things have improved."

How can our elected officials do anything when they're bought and paid for by the very industries that they're attempting to change/regulate?