Confused about health care reform? Don't worry, you're not alone.
The nearly $1 trillion makeover signed into law by President Barack Obama on March 23 for the first time guarantees insurance coverage as the right of every U.S. citizen. News coverage of the reform effort focused as much, or more, on political wrangling as on the substance of the measure.
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So we're going to try to describe one aspect of health care reform in plain English.
That's not easy. For one thing, the bill Obama signed is full of sentences that begin with things like: "For the purposes of subparagraph 6(b) . . . " For another, health care reform is the most sweeping change in U.S. domestic policy in a generation. It's big, and it's complicated.
But here's a key thing to remember: There is a simple concept at the center of this complicated machine. Reform expands insurance coverage in America by requiring that people obtain it.
That's right, the new legislation mandates that most U.S. citizens and legal residents purchase "minimal essential coverage" for themselves and their dependents. They can either get this through their employer, or, if their employer doesn't offer health insurance, buy it through new "exchanges" that would sell policies to individuals.
Are there penalties if you don't buy insurance?
Under the measure, if you ignore the mandate and don't get health insurance, you would pay a penalty to the federal government, beginning in 2014. The fine would start fairly small, but by the time it is fully phased in, in 2016, it would be substantial.An insurance-free person would have to pony up whichever is greater: $695 annually for each uninsured family member -- up to a maximum of $2,085 -- or 2.5% of household income.
There are exceptions. Certain people with religious objections would not have to get health insurance, nor would American Indians, illegal immigrants or people in prison.
Why the requirement?
It's a pretty obvious way to expand coverage, for one thing. Also, it would help bring in a flood of new customers for health insurers, including healthy young people who might not need much health care.
For insurance companies, those new customers would balance out the losses they would incur by ending the practice of denying coverage to people with pre-existing conditions, something the measure outlaws.
And many people would not be buying coverage purely on their own; Uncle Sam would help them. The bookend to the individual mandate is a federal subsidy to purchase insurance that reaches deep into the middle class.
This article was reported by Peter Grier for The Christian Science Monitor.
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