Friday, August 8, 2014

qotd: Most uninsured will be exempt from penalties

The Wall Street Journal
August 6, 2014
Fewer Uninsured Face Fines as Health Law's Exemptions Swell
By Stephanie Armour

Almost 90% of the nation's 30 million uninsured won't pay a penalty
under the Affordable Care Act in 2016 because of a growing batch of
exemptions to the health-coverage requirement.

The architects of the health law wanted most Americans to carry
insurance or pay a penalty. But an analysis by the Congressional Budget
Office and the Joint Committee on Taxation said most of the uninsured
will qualify for one or more exemptions.

The Obama administration has provided 14 ways people can avoid the fine
based on hardships, including suffering domestic violence, experiencing
substantial property damage from a fire or flood, and having a canceled
insurance plan. Those come on top of exemptions carved out under the
2010 law for groups including illegal immigrants, members of Native
American tribes and certain religious sects.

Factoring in the new exemptions, the congressional report in June
lowered the number of people it expects to pay the fine in 2016 to four
million, from its previous projection of six million.


Congressional Budget Office
June 5, 2014
Payments of Penalties for Being Uninsured Under the Affordable Care Act:
2014 Update

Under the Affordable Care Act, most legal residents of the United States
are required to obtain health insurance or pay a penalty.

CBO and JCT have estimated that about 30 million nonelderly residents
will be uninsured in 2016 but that the majority of them will be exempt
from the penalty. Those who are exempt include:

* Unauthorized immigrants, who are prohibited from receiving almost all
Medicaid benefits and all subsidies through the insurance exchanges;
* People with income low enough that they are not required to file an
income tax return;
* People who have income below 138 percent of the federal poverty
guidelines (commonly referred to as the federal poverty level) and are
ineligible for Medicaid because the state in which they reside has not
expanded eligibility by 2016 under the option provided in the ACA;
* People whose premium exceeds a specified share of their income (8
percent in 2014 and indexed over time); and
* People who are incarcerated or are members of Indian tribes.

CBO and JCT estimate that 23 million uninsured people in 2016 will
qualify for one or more of those exemptions. Of the remaining 7 million
uninsured people, CBO and JCT estimate that some will be granted
exemptions from the penalty because of hardship or for other reasons.

All told, CBO and JCT estimate that about 4 million people will pay a
penalty because they are uninsured in 2016 (a figure that includes
uninsured dependents who have the penalty paid on their behalf).


Comment by Don McCanne

The Affordable Care Act was designed with incentives for almost everyone
to obtain insurance. A financial penalty was to be assessed against any
individual who remained uninsured, but now almost 90 percent of the
uninsured will be exempt from the penalty. Larger employers were to be
penalized if their employees remained uninsured, but now there is
bipartisan support to eliminate the employer mandate. The expansion of
Medicaid was to occur in all states but it has now been declined by
about half of the states. Even with legislative patches, this fragmented
system can never ensure that everyone has adequate health care coverage.

Compare this to a single pager system in which absolutely everyone would
have been automatically enrolled in a better plan than any of those
currently available, including Medicare. Why is there no clamoring for

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