Here’s how the Obama administration wants the Obamacare individual mandate to work.
The IRS and Department of Health and Human Services proposed new rules Wednesday pertaining to the Affordable Care Act’s requirement that uninsured taxpayers purchase health insurance, and expanded the circumstances under which Americans may receive an exemption from the so-called “individual mandate.”
Churches, illegal immigrants, incarcerated individuals and members of Native American communities are excluded from the individual mandate, which takes effect in 2014. The new proposed rules issued jointly by the Center for Medicare and Medicaid Services and IRS detail four more categories of Americans who should be eligible for exemptions in any given year.
These exemptions cover taxpayers whose incomes fall below the filing threshold, individuals who cannot afford a plan at any time during the year on their state’s insurance exchange, individuals who fall into a coverage gap created by the Supreme Court’s recent ACA decision making the law’s Medicaid expansion optional for states; and certain individuals who go without insurance for less than three months.
The ACA stipulates that people who allow coverage to lapse for more than three months will trigger mandate’s penalty. The Treasury Department has provided leniency for individuals whose coverage gap extends across two calendar years (November through February, for instance) noting that uninsured taxpayers might not have reached the three month threshold at the time they file their taxes.
The administration is seeking comment on the proposed rules for what it’s calling the “individual shared responsibility provision,” which will be finalized later this year.
Sahil Kapur is a congressional reporter for TPM. He previously covered politics and public policy for numerous publications including The Guardian and The Huffington Post. He can be reached at sahil [at] talkingpointsmemo.com.