The Big Story Blog

Coming Tuesday: Can Congress make me buy insurance?

Posted at 4:12 PM on March 26, 2012 by Paul Tosto
Filed under: Health

supco222.jpg
BRENDAN SMIALOWSKI/AFP/Getty Images

The Supreme Court kicked of several days of oral arguments today on the constitutionality of President Obama's health care law. But the law's real fireworks start on Tuesday.

That's when the Court focuses on perhaps the critical question of the two-year-old health care law: Can Congress compel Americans to buy health insurance pay a penalty should they refuse?

Today, the question was much more pedestrian, with the justices taking on the question of whether an 1867 law would preempt the Court from even looking at the constitutionality of the Affordable Care Act. National Public Radio reports:

The administration and the challengers to the overhaul law don't agree on much. But both sides agreed that the Anti-Injunction Act, which says people can't challenge a tax in court before they pay it, should not prevent the Supreme Court from deciding the constitutionality of the law.
NPR reporters seemed convinced that this will not be a roadblock to the Court ruling this year on the law.

The mandate to buy insurance or face a penalty is certainly the most politically contentious.

For the Supreme Court, though, the main question here is whether health insurance is a product so distinctive that it triggers interstate commerce powers of Congress, which means Congress would have power to mandate coverage, Brown University political science professor James Morone told MPR News. "It seems like it's quite a plausible argument," he added.

So, what is the mandate, who's affected and how much will it cost?

The Kaiser Family Foundation has a nice synopsis:

Starting in 2014, most people will be required to have health insurance or pay a penalty if they don't. Coverage may include employer-provided insurance, coverage someone buys on their own, or Medicaid.

Several groups are exempt from the requirement to obtain coverage or pay the penalty, including: people who would have to pay more than 8% of their income for health insurance, people with incomes below the threshold required for filing taxes (in 2009, $9,350 for a single person and $26,000 for a married couple with two children), those who qualify for religious exemptions, undocumented immigrants, people who are incarcerated, and members of Indian tribes.

The penalty for people who forego insurance is the greatest of two amounts: a specified percentage of income or a specified dollar amount. The percentages of income are phased in over time at 1% in 2014, 2% in 2015, and 2.5% starting in 2016.

The dollar amounts are also phased in at $95 in 2014, $325 in 2015, and $695 beginning in 2016 (with annual increases after that). The Congressional Budget Office projects that 3.9 million people will pay the penalty in 2016. The total penalty for the taxable year will not exceed the national average of the annual premiums of a bronze level health insurance plan offered through the health insurance Exchanges.

Health insurance plans will provide documents to people they insure that will be used to prove that they have the minimum coverage required by law.

We'll get a better idea on Tuesday where the court might be headed on this when we hear the oral arguments made and questions asked.


About Paul Tosto

Paul Tosto

Paul Tosto writes the Big Story Blog for MPR News. He joined the newsroom in 2008 after more than 20 years reporting on education, politics and the economy for news wires and newspapers across the country.