If you don’t have to pay, is it still a Mandate?

First off, a disclaimer: I don’t like the Affordable Care Act (Obamacare). While it guarantees that a lot of people will have health insurance, it does nothing about making certain people have health care.  There are millions of folks that can’t afford the copays and deductibles and medicines needed, so having “insurance” doesn’t help them at all.  While I’m not one of those folks, a couple of missed paychecks would make me one.  And with my health situation, that would quickly become fatal.  So I have a vested interest in this topic.  But those issues aren’t what most people are yelling about.  Instead, they’re all upset about the “mandate”.  But is the mandate a false target?  Consider this…

The Health Care and Education Reconciliation Act of 2010, also called the Affordable Care Act, has received a lot of flack — mostly for things that aren’t true.  But one thing is certain: if you don’t buy insurance, you must pay a fine/tax.  Or is it?  It’s estimated that 98% of the population either already has insurance, will buy insurance, or is exempt for other reasons.  On top of that, in spite of what you might have heard, the IRS won’t be hunting you down if you don’t pay up.

In the original version of the Act, there was a hefty penalty attached to the act of not buying insurance.  Without a large fine, some people would just ignore the mandate and only buy insurance when they became ill.  With insurance companies forced to accept everyone regardless of pre-existing condition, why not?  So the IRS was given the job of collecting payment.  If you didn’t pay the fine then the IRS would, indeed, treat you as a tax criminal.

But that version was unable to gain enough supporters to pass through the Senate.  So, the bill was rewritten, and the penalty was reduced to almost nothing.  That, too, didn’t pass.  So the bill was rewritten again, this time to remove the enforcement clause.  In other words, the Act, as currently written, not only has a small fine (i.e., it’s cheaper to pay the fine than to buy the insurance), they can’t make you pay it. The IRS will still be collecting the fine (that, in part, is why SCOTUS decided that the penalty was actually a tax), but they are specifically banned from using their normal tools to enforce payment.

Which brings us back to the headline: if you don’t have to pay, is it still a Mandate?  I’m not sure about the answer, but I do know this: health insurance is not the same as health care, no matter how you define it…

Sources: Forbes , Utne, Wikipedia

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