The Basics

• Approach
• Individual Mandate
• Employer Requirements
• Expansion of Public Programs
• Premium & Cost-Sharing subsidies to Individuals
• Insurance & Finance Health Reform
• Health Insurance Exchanges
• Benefit Design
• Changes to Private Insurance
• State Role
• Health System Performance
• Prevention Wellness
• Long Term Care
• Other Investments

Requirement to Have Coverage:

U.S. Citizens and legal residents are required to have qualifying health coverage. Those without coverage pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income. The penalty will be phased-in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016.

Beginning after 2016, the penalty will be increased annually by the cost-of-living adjustment. Exemptions will be granted for financial hardship, religious objections, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals, those for whom the lowest cost plan option exceeds 8% of an individual’s income, and those with incomes below the tax filing threshold (in 2009
the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).

 

 

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