This is an archived article that was published on in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The mass shooting in Colorado has hospitalized dozens of victims, many of them young adults. Because one of the largest groups of Americans without health insurance is young adults between the ages of 18 and 34, chances are high that many of these victims are uninsured.

Hospitals treating 22 of those people announced the other day that they would limit or forgive many of their medical bills. That's a wonderful thing.

But the situation highlights a gap in health insurance coverage that the Affordable Care Act, otherwise known as Obamacare, is designed to address. It also helps to make the case for the individual mandate.

Federal law requires hospitals to stabilize patients who require emergency care without regard to their ability to pay. But if they are uninsured and cannot afford to pay their bills, the money must come from somewhere. Hospitals use financial reserves derived from the payments of people who are insured to cover those losses. Eliminating that cost-shifting is one reason for the individual mandate, the requirement that everyone have insurance.

By broadening the insurance pool, the mandate also should help to make insurance more affordable. Medicaid will be expanded to cover more low-income single adults, and new taxes will subsidize individual insurance. Cost is one reason why young adults don't buy insurance now.

But will it work? The truth is that no one really knows, though Romneycare in Massachusetts, which is the model for Obamacare, has worked passably well. One of the supreme ironies of the current presidential campaign is that both candidates championed essentially the same plan, one in a state, the other for the nation.

Yet Mitt Romney insists that Obamacare will cost the country trillions of dollars, exacerbate the federal deficit and weigh on the economy. Obama claims it won't. Romney has vowed to repeal Obamacare.

The nonpartisan Congressional Budget Office agrees with Obama, at least on the deficit. It estimates that if the Repeal of Obamacare Act, passed by the U.S. House earlier this month, became law, it actually would make the federal budget deficit worse by $109 billion over the 2013–2022 period. That's because repeal would save $890 billion in spending but also eliminate $1 trillion in revenue.

But by any measure, a system that requires everyone to carry insurance makes sense. When Romney campaigned for it in Massachusetts, he called it personal responsibility. He was right.