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Individual, Employer Mandates Prove Thorny Topics For Lawmakers

When President Clinton proposed requiring all Americans to buy insurance in the early 1990s, the non-partisan Congressional Budget Office called it "an unprecedented form of federal action," adding that "[t]he government has never required people to buy any good or service as a condition of lawful residence in the United States," the Los Angeles Times reports. The current House reform bill unveiled last week, would require Americans to do just that, drawing the ire of libertarians and conservatives who see grounds for a constitutional challenge. One libertarian think-tanker said, "What next? Can Congress order you to buy spinach?"

"The newly unveiled House bill would set a tax penalty of as much as 2.5% of adjusted income for people who do not have health insurance as of 2013. The Senate Finance Committee scaled down its penalty, but settled on a maximum of $750 per adult, or $1,500 for a household. A Senate version of the bill says the IRS could only enforce the penalty by subtracting it from any refund owed to the taxpayer," the Times reports.

Supporters say the logic is similar to the requirement that Americans have liability insurance to cover costs to others in the event of an accident if they want to drive. "If a person without coverage is hurt in an accident and sent to the hospital, he might run up huge medical bills that he cannot pay, which would then be absorbed by others with insurance or by taxpayers" (Savage, 11/1).

All three bills in Congress - two in the Senate and the new House bill - would also require employers to provide coverage, or at least penalize those who do nothing, The New York Times reports. "The House version is generally viewed as the most worker-friendly. It would require employers to pay 72.5 percent of the costs of benefits for employees who are single, and 65 percent for employees with families. It would exact penalties for non-compliance on a sliding scale depending on the size of a company's payroll, going up to 8 percent for those with a payroll over $750,000." Meanwhile, the Senate Finance Committee bill lays out no requirements, but penalizes employers that do not at least offer some coverage (Seeyle, 10/31).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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