Thursday, June 28, 2012

NO, you are NOT required to buy insurance if you can't afford it

Let me get this one out of the way quickly.  People all over the internet are complaining that the individual mandate is going to make them buy something they can't afford.  This is NOT TRUE.

Section 5000A says you have to have "minimum essential coverage" -- insurance, Medicaid, Medicare, etc. -- or you pay a penalty.  The amount of the penalty depends on a lot of things, including your income.

What people are missing is the EXEMPTIONS.  The law says "NO penalty shall be imposed under subsection (a) with respect to (1) INDIVIDUALS WHO CANNOT AFFORD COVERAGE."  That's a direct quote from Section 5000A(e)(1).  If you would have to pay more than 8 percent of your household income EVEN WITH the government subsidies that will be available to all Americans who earn up to 400 percent of federal poverty level (between $80-90,000 per year) -- so if the portion YOU have to pay is more than 8 percent of your household income and you still refuse to buy insurance -- THEN AND ONLY THEN would you have to pay a penalty.

Understand that, currently, if someone doesn't want to buy insurance -- they can afford it but they just don't want to -- and they get sick or in a car accident and end up in an emergency room but then they can't pay their bill, the federal government pays that bill with taxpayer dollars.  It's called uncompensated care, and the federal government pays BILLIONS of dollars to hospitals to cover bills that aren't paid.  That's your tax dollars at work.  Is it fair for someone who CAN afford to buy insurance to dump that cost on the rest of us?

One of the original plaintiffs in the case against the health reform law said she didn't want to buy insurance.  While the case was pending, she got sick.  She couldn't pay her medical bills.  She filed for bankruptcy, leaving the taxpayers holding the bag to pay for her care.  Is that fair?

Far from being unfair to people who cannot afford insurance, the law will help those people with very substantial subsidies -- and stop forcing taxpayers to foot the bill for people who figure they can game the system and avoid paying for health insurance or health care!  Sounds pretty fair to me.

Still reading.  More later.  Jennifer

1 comment:

  1. Thanks for your updates and commentary on the Affordable Care Act. As both a lawyer (though not a health lawyer!) and a person living with chronic illness, I really appreciate your analysis.