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White House Proposes Individual Mandate Rules

Cheryl Clark, for HealthLeaders Media, January 31, 2013

Individuals who go without coverage for less than three months in any year are exempted from having to pay the penalty.

The rules also spell out several categories of coverage that would not be considered minimum essential coverage.

They include accidental death and dismemberment coverage, disability insurance, general liability insurance, automobile liability insurance, workers' compensation, credit-only insurance such as mortgage insurance, and coverage for employer-provided on-site medical clinics. 

Also not considered acceptable coverage are limited-scope dental or vision benefits, long-term care benefits, and benefits provided under certain health flexible spending arrangements.

A third category not considered minimum essential coverage are policies covering "only for a specified disease or illness (for example, cancer-only policies) or fixed indemnity insurance (for example, a policy that pays a fixed dollar amount, such as $100, per day of hospitalization or illness regardless of the amount of medical expense incurred.)"

The fourth category of coverage not considered minimum essential coverage would be policies separate from primary health coverage, Medicare supplemental policies (Medigap or MedSupp insurance), TRICARE supplemental policies, and similar supplemental coverage under a group health plan.

A public hearing is scheduled for May 29. Comments on the HHS proposed rule are due by March 18 and for IRS proposed rule May 2.

The American Hospital Association said it would not have a comment until it had finished reviewing the rules.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "White House Proposes Individual Mandate Rules"


Jim Koepke (2/1/2013 at 2:41 PM)
Could this be any more complicated? This is why government makes a disaster out of everything it touches. Just miles and miles of bureaucratic red tape and nonsense.