Your Source for Health Reform

Topic: Individual Mandate



The ACA requires that everyone have health coverage in some form. Those who not have insurance, and do not fall into one of the exemption categories, are subject to a penalty. The penalty fee is $95 or prorated 1% of income for 2014, and increases in later years. The constitutionality of this part of the law was challenged, and was upheld by the U.S. Supreme Court.


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The Case for the Individual Mandate in Health Reform

In this February 2012 study, the Center for American Progress examines “why the individual mandate is an essential pillar of comprehensive health care reform.” It notes that in states that tried market reforms without a mandate, premiums increased and enrollment declined, while in Massachusetts reform that included a mandate resulted in near universal coverage. (more…)

The Requirement to Buy Coverage

Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. This simple flowchart by the Kaiser Family Foundation illustrates how that requirement (sometimes known as an “individual mandate”) works.

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