A 27-year-old marketing associate in Boston earning $60,000 a year will spend well over a third of her income on rent. Add the cost of student loan payments, groceries, and transportation, and there’s little room left for health insurance. But unless she chooses a high-premium health insurance plan, the Commonwealth of Massachusetts could penalize her at tax season to the tune of thousands of dollars.

As part of Governor Mitt Romney’s 2006 health care reforms, Massachusetts required residents to carry health insurance, with few exceptions. Known as an “individual mandate,” the law sought to ensure all residents carried a minimum level of coverage. The goal was to bring more healthy residents into insurance pools and balance costs for those with more serious conditions.

By manipulating prices, the government places a heavy burden on the working class and limits financial freedom. Only those in extreme poverty, making less than $24,000 per year, are exempt from Massachusetts’ penalties on residents without coverage.

Under Obamacare, a similar requirement applied nationwide. Today, Massachusetts is one of only five states that still maintain a state-level mandate after President Donald Trump repealed the federal requirement in 2017. For young residents navigating unstable early-career incomes and mounting expenses, the mandate reduces financial flexibility at exactly the moment it is needed most.

If Massachusetts is serious about affordability, it should repeal the individual mandate and allow young adults to make their own financial and health care decisions.

For young adults, financial stability depends on flexibility. Early career years often include job changes, relocations, contract work, graduate school, and side hustles.

Income fluctuates, with entry-level salaries in Boston ranging from $47,100 to $59,200 annually. Expenses can spike unexpectedly. The ability to decide where each dollar goes, toward rent, debt repayment, emergency savings, or professional development, can determine whether someone gets ahead or falls behind.

But Massachusetts undermines that freedom of choice by imposing insurance requirements. Penalties for choosing not to carry health insurance can exceed $2,000, roughly the equivalent of Boston’s average monthly rent for a studio apartment. For people living paycheck to paycheck, yet earning slightly too much to qualify for the government’s exemption, that penalty is simply infeasible.

Health care decisions should belong to individuals, not politicians. A healthy person in their late twenties or early thirties may reasonably decide to direct limited income toward building an emergency fund rather than paying high monthly premiums for coverage they rarely use. Some may choose a health savings account, free clinics, or naturopathic options.

The mandate removes that discretion and replaces it with a one-size-fits-all rule.

Ending the individual mandate and focusing instead on true health outcomes and insurance costs would make Massachusetts more affordable for the next generation, a priority highlighted in Gov. Maura Healey’s recent State of the Commonwealth address. Few have discussed eliminating the mandate, but the political opportunity exists.

While Congress remains stagnant on rising health care costs, the Commonwealth can lead with a bold agenda focused on providing coverage where it is needed and at prices people can afford. Letting citizens choose their own health care expenditures would only be the beginning. Many approaches will likely be necessary to make health insurance more affordable in Massachusetts. But one thing is certain: it will not come from an individual mandate.

Sam Raus is the David Boaz Resident Writing Fellow at Young Voices, a political analyst and public relations professional. Follow him on X: @SamRaus1.