Last updated on: 8/31/2010 | Author:

Will the government help me if I cannot afford mandatory health insurance?

General Reference (not clearly pro or con)


[Editor’s Note: The following sections of the Patient Protection and Affordable Care Act (HR 3590) (2 MB) , signed into law by President Barack Obama on Mar. 23, 2010, pertain to the options available for low income individuals who cannot afford private health insurance. Title I, Subtitle E, Part I of HR 3590 was amended by the Health Care and Education Reconciliation Act of 2010 , signed into law on Mar. 30, 2010:

1. Title I, Subtitle D, Part IV

A. Section 1331. State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid.  (Page 81 – 85)

2. Title I, Subtitle E, Part I

A. Sec. 1401. Refundable tax credit providing premium assistance for coverage under a qualified health plan.  (Page 95 – 201)

i. Amended by the Health Care and Education Reconciliation Act of 2010, Title I, Subtitle A, Sec. 1001. Tax Credits.  (Page 2 – 4)

B. Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health plans.   (Page 102 – 106)

3. Title I, Subtitle F, Part I

A. Section 1501. Requirement to maintain minimum essential coverage.  (Page 124 – 131)

4. Title II, Subtitle A

A. Section 2001. Medicaid coverage for the lowest income populations.  (Page 153 – 161)

5. A summary of the sections above are available in the Democratic Policy Committee’s (DPC’s) report “The Patient Protection and Affordable Care Act: Section-by-Section Analysis with Changes Made by Title X and Reconciliation included within Titles I-IX ]

PRO (yes)


The Kaiser Family Foundation (KFF), provided the following in its “Summary of Coverage Provisions in the Patient Protection and Affordable Care Act,” available on its website (accessed May 10, 2010):

“Individuals who do not have access to affordable employer coverage will be able to purchase coverage through a health Insurance Exchange with premium and cost-sharing credits available to some people to make coverage more affordable…

All individuals will be required to have health insurance, with some exceptions, beginning in 2014… Exceptions will be given for financial hardship and religious objections; and to American Indians; people who have been uninsured for less than three months; those for whom the lowest cost health plan exceeds 8% of income; and if the individual has income below the tax filing threshold ($9,350 for an individual and $18,700 for a married couple in 2009)…

Medicaid will be expanded to all individuals under age 65 with incomes up to 133% of the federal poverty level ($14,404 for an individual and $29,327 for a family of four in 2009) based on modified adjusted gross income…

Eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) for children will continue at their current eligibility levels until 2019. People with incomes above 133% of the poverty level who do not have access to employer sponsored insurance will obtain coverage through the newly created state health insurance Exchanges.”

May 10, 2010


The New York Times provided the following in its Prescriptions blog’s June 2, 2010 post “Will Insurance Be Given to Those Who Can’t Afford It?” by Michelle Andrews:

“Since the health care law expands the Medicaid program to cover adults with incomes up to 133 percent of the federal poverty level ($19,378 for two people in 2009/2010), you may qualify for Medicaid coverage.

If your employer offers insurance but your contribution would exceed 9.5 percent of your income, you can go onto the health insurance exchanges and look for coverage there. People with incomes up to 400 percent of the poverty level ($58,280 for a couple in 2010) can qualify for subsidies to help make coverage more affordable.

But if even the least-expensive plan on the health insurance exchange would exceed 8 percent of your income, you will not be required to buy it. In that case, said Mr. Park, ‘you remain uninsured, but you won’t be penalized for it.'”

June 2, 2010

CON (no)


[Editor’s Note: We have been unable to find any cons to this question, and if you know of any, please let us know. Aug. 23, 2010]