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Individual Mandate More Like Suggested Donation

Philip Betbeze, for HealthLeaders Media, February 1, 2013

What's the point of issuing individual mandate rules, as the White House did this week? Of course it has to be done by statute, but what does the sound and fury signify? Apparently not much.

Through a pair of documents, one from the IRS and one from the Department of Health and Human Services , the Obama administration has issued a set of proposed rules surrounding one of the most controversial parts of the Patient Protection and Affordable Care Act for public hearing.

The most surprising news about the proposed rules is that it appears exemptions built into them for enforcing the individual mandate are so permissive that only 2% of the population would owe a penalty.

Wait a second. I thought that by the time of the passage of the PPACA in 2010, 46 million people were uninsured. That number was heatedly disputed then, but even taken as fact, it represents about one sixth of the total United States population of about 313 million, or around 17%.

Since most of the provisions surrounding the health insurance portion of the law won't go into effect until next year, the number of uninsured must be at least as high now.

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2 comments on "Individual Mandate More Like Suggested Donation"


Todd Madden (2/2/2013 at 9:57 AM)
Given the low reimbursement somehow state hospital associations are aggressively campaigning for states to expand Medicaid claiming it will reduce the cost shift! So let me get this straight, if a state expands Medicaid (subsidizing something encourages more utilization), but there are still significant uninsureds and more people turning 65 and no significant increase in primary care providers, that somehow there will be less cross subsidization? Seems like a recipe for more ER visits not less.

alex eaton (2/1/2013 at 2:55 PM)
IRS to accept "suggested donations" the notion offends me.