Skip to content
Link copied to clipboard

Understanding the latest fight over the individual mandate

WASHINGTON - In the latest war over the Affordable Care Act, the GOP is essentially trying to encourage Americans everywhere to seek an exemption from the individual mandate, the health-care law provision that requires everyone to get insurance by March 31 or face a penalty.

WASHINGTON - In the latest war over the Affordable Care Act, the GOP is essentially trying to encourage Americans everywhere to seek an exemption from the individual mandate, the health-care law provision that requires everyone to get insurance by March 31 or face a penalty.

The Obama administration says exemptions are much more limited than the GOP would have you believe.

Separately, the Republican-controlled House passed a bill Friday that would delay the individual mandate until 2018. Under this legislation, 13 million fewer people would have insurance in 2018 than if the mandate remained in place, the Congressional Budget Office said.

Behind the renewed attacks are the GOP's hatred of the mandate. The provision is unpopular, but administration officials and insurers view it as a critical component of the law. Its main purpose is to prevent people from waiting until they're sick to sign up for insurance - a scenario that would drive up insurance costs for everyone else.

The twin attacks aren't surprising. The GOP has been trying to undermine the individual mandate from the moment what they call "Obamacare" was signed into law. The vote in the House is of little consequence because the bill has almost no chance of passing the Senate.

But the GOP's exemption argument has the potential to be more disruptive. The exemptions are real. Back in December, the administration spelled out 14 types. This week, the GOP has focused on two in particular.

The first one has to do with canceled plans. The administration said in December that people whose individual health plans were canceled last year wouldn't have to pay the penalty in 2014 if they remain uninsured. Those people also have the option of purchasing cheaper catastrophic plans. Just last week, the White House extended that exemption for two more years.

The other focus has been on a vague hardship exemption. People can avoid penalties if they "experienced another hardship in obtaining health insurance." This language is pretty broad. And those who claim hardship don't have to provide documentation. So, doesn't this mean anyone can just claim hardship and avoid the penalty for not having insurance? The GOP is arguing as much.