Individual Mandate

The Affordable Care Act requires that most individuals will be required (mandated) to purchase a comprehensive health insurance policy or else pay a penalty.  This is more commonly referred to as the Individual Mandate.  In 2012 Congress upheld the constitutionality of the mandate as it was determined to be a tax.  It is estimated that once ACA is fully enacted an additional 32 million Americans (and over 800,000 North Carolinian’s) will be insured.  In order to supply coverage to this many the individual mandate is a very crucial key to the success (or failure) of the ACA.

For folks that get their coverage through an employer the individual mandate won’t mean anything to them since they already have coverage.  For the thousands that don’t have access to employer coverage a large percentage of North Carolinian’s will receive substantial federal subsidies that offset the price of the premiums (click here to learn more about the subsidies).  For those that don’t qualify for the subsidy you are likely looking at much higher insurance premiums than what you have today.

So what is the penalty if you go without health insurance?

  • $695 annually or 2.5% of an individual’s income, whichever is greater, in 2016 and thereafter

However we feel that most people do want to be covered and most will purchase the coverage (especially if you qualify for a subsidy…why wouldn’t you!).  We are also thinking that once ACA is fully implemented and running the individual mandate penalties will be increased…they need to be AT LEAST the amount of the least expensive plan available.

For those that DO NOT purchase coverage:

Many people are probably saying to themselves that since it is guaranteed issue and I can’t be turned down I will just buy the coverage once I become ill or have an accident.  Well that would be like driving without car insurance then buying coverage once you wreck the car….it doesn’t work like that.

While it is true you cannot be turned down; the problem is that you can only purchase coverage during the Annual Enrollment Period (November 1st thru January 31st) of each year.  Imagine not getting the coverage and you get cancer or have a stroke in February.  Next thing you know you have $300,000 in medical bills and lose everything.  It’s not worth it.

Take our advice and comply with the Individual Mandate and purchase coverage…even if it is minimal.  Not sure what to do, just complete the form to the right and we will help guide you through your options.

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