Last updated on: 1/5/2018 | Author: ProCon.org

Are There Any Exemptions to the Mandatory Health Insurance Requirement? – YES

General Reference (not clearly pro or con)

[Editor’s Note: Beginning in 2019 the mandate to purchase health insurance or pay a tax fine will officially end. The Tax Cuts and Jobs Act, signed into law by President Trump on Dec. 22, 2017, contained a provision repealing the individual mandate to purchase health insurance under Obamacare. The mandate will remain in effect for 2018.]

The Patient Protection and Affordable Care Act, Section 1411, page 107, “Procedures for Determining Eligibility for Exchange Participation, Premium Tax Credits and Reduced Cost-Sharing, and Individual Responsibility Exemptions,” signed into law on Mar. 23, 2010, available at the Library of Congress website, states:

“(5) EXEMPTIONS FROM INDIVIDUAL RESPONSIBILITY REQUIREMENTS.—

In the case of an individual who is seeking an exemption certificate under section 1311(d)(4)(H) from any requirement or penalty imposed by section 5000A, the following information:

(A) In the case of an individual seeking exemption based on the individual’s status as a member of an exempt religious sect or division, as a member of a health care sharing ministry, as an Indian, or as an individual eligible for a hardship exemption, such information as the Secretary shall prescribe.

(B) In the case of an individual seeking exemption based on the lack of affordable coverage or the individual’s status as a taxpayer with household income less than 100 percent of the poverty line, the information described in paragraphs (3) and (4), as applicable.”

Mar. 23, 2010 - Patient Protection and Affordable Care Act (HR 3590)
[Editor’s Note: On Aug. 27, 2013, the Obama administration released the final regulations for Obamacare’s individual mandate including how the fines for people who chose not to purchase will be assessed, who it applies to, who is exempt, and the types of insurance that are necessary to meet Obamacare’s health insurance mandate.]

PRO (yes)

Pro

Julie Rovner, NPR Health Policy Correspondent, wrote in her July 6, 2012 article “More Answers to Your Questions About the Health Care Law,” available at www.npr.org:

“For starters, if you don’t earn enough to have to file a federal tax return, you’re exempt. In 2010 that was $9,350 for an individual, or $18,700 for a married couple.

You’re also exempt if you would have to pay more than 8 percent of your household’s income for health insurance, after whatever help you might get from an employer or subsidies from the federal government…

[T]he VA counts [as having insurance]. So does TRICARE and other military health plans. In fact, just about all government health care program[s], including Medicare and Medicaid, count as well. That’s why the Urban Institute estimates that come 2014, only about 7 million people out of the U.S. population of well over 300 million will have to either purchase insurance or be subject to paying the penalty.”

Pro

Diane Suchetka, Staff Writer for the Plain Dealer, wrote in her June 29, 2012 article “Affordable Care Act’s Mandate Does Not Require Everyone to Buy Insurance,” available at the Cleveland, Ohio website:

“Who doesn’t have to buy insurance?

• American Indians, prisoners and undocumented immigrants.

• Some religious groups. Those that have historically been exempt from the Social Security system, such as the Old Order Amish, are one example. Religious groups whose members pay for one another’s health care instead of buying insurance are also exempt.

• Those whose family income is so low they don’t have to file a tax return. Those numbers vary depending on several factors, including how old you are, whether you’re married and whether you’re the head of your household.

• Those who earn so little that health insurance premiums, after federal subsidies and employer contributions, would total more than 8 percent of their income.

• Those who already have insurance through Medicaid, Medicare, an employer or veteran’s health program.”

CON (no)

Con

[Editor’s Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Pro (yes) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]