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Supreme Court rules on health care mandate

Many US citizens are unclear what the recent Supreme Court ruling on health care will mean to them.

Here is the issue as defined by the Supreme Court :

"In 2010, Congress enacted the Patient Protection and Affordable Care Act in order to increase the number of Americans covered by health insurance and decrease the cost of health care. One key provision is the individual mandate, which requires most Americans to maintain "minimum essential" health insurance coverage. 26 U. S. C. §5000A. For individuals who are not exempt, and who do not receive health insurance through an employer or government program, the means of satisfying the requirement is to purchase insurance from a private company. Beginning in 2014, those who do not comply with the mandate must make a "[s]hared responsibility payment" to the Federal Government. §5000A(b)(1). The Act provides that this "penalty" will be paid to the Internal Revenue Service with an individual's taxes, and "shall be assessed and collected in the same manner" as tax penalties. §5000A(c), (g)(1). "

And here is the ruling:

"CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part III-C, concluding that the individual mandate may be upheld as within Congress's power under the Taxing Clause."

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The mandate means the following:

  • Beginning in 2014, most individuals will be responsible for obtaining "minimum essential coverage" or must pay a penalty which is the greater of :
    • $95 in 2014, $350 in 2015, $695 in 2016
      or
    • a percentage of income (capped at 2% of the cost of the lowest level of coverage)
  • Families will pay half the amount for children up to $2,085 per family.
  • After 2016, annual amounts will increase by the cost of living adjustment.
  • Exceptions exist for religious objectors, those who cannot afford coverage, taxpayers with incomes less than 100 percent FPL, Indian tribe members, those who receive a hardship waiver, individuals not lawfully present, incarcerated individuals, and those not covered for less than three months.

Minimum essential coverage is provided by:

  • Certain government sponsored programs including medicare and medicaid.
  • Coverage under an eligible employer-sponsored plan.
  • Coverage under a health plan offered in the individual market within a State.
  • Coverage under a grandfathered health plan.
  • Such other health benefits coverage, such as a State health benefits risk pool, as the Secretary of Health and Human  Services recognizes.

What people are saying:

" Now that the Supreme Court has issued their decision, we know that all parts of the law remain in full force and implementation will continue as planned.  Most of the law’s major provisions become effective in 2014 including the individual and employer mandates.  We can expect guidance about many of these provisions to be issued in the coming months and will be able to answer the questions that have lingered since March of 2010.  The effect of ACA will vary from employer to employer, depending on company size, plan design and policies for providing benefits.  At CGF, we take an active role in helping employers, employees and their families understand their benefits.  We will continue to do so in this changing environment."

-- Becky Barlow, Executive Director
   California Growers Foundation