Wednesday, January 30, 2013

Feds: No ACA mandate for those in coverage hole

Posted by on Wed, Jan 30, 2013 at 5:30 PM

The Department of Health and Human Services released clarifications today regarding exemptions from the healthcare law's individual mandate. The headline is that they're proposing a specific exemption for anyone who might fall in the coverage hole if states choose not to expand Medicaid. The Affordable Care Act already has exemptions for anyone that can't afford coverage built in to the law so in practice anyone under 100 percent of the federal poverty level would be exempt anyways.

Though it's redundant, it doesn't hurt to be crystal clear. This ensures that we won't end up with a nightmare scenario of a low-income person getting hit with a penalty under the mandate despite having no Medicaid eligibility or subsidies.

That said, without expansion, we will still have the "upside down" situation of folks between 100 and 400 FPL getting government subsidies, while most people under 100 FPL are left out in the cold.

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