Health Care Reform is an Individual Mandate

Health Care Reform Act in its entirety

The concept behind “ObamaCare” is that the individual must purchase health insurance coverage for himself or herself and his or her dependents. Check it out on page 143 of the ACT shown above. You can’t pay for healthcare services as you use them; you must first purchase health insurance.

If you’re self-employed, you must purchase health insurance. If you work part-time and your employment does not provide health insurance, you must purchase health insurance. If you work full-time and you don’t like the health insurance policy provided by your employer, you must still purchase health insurance from somewhere.

Purchasing health insurance doesn’t guarantee access to healthcare; it only means that you have prepaid for future healthcare services, as long as you continue to pay the monthly insurance premiums, and IF you can find the healthcare services.

I speak of “finding” health care services because of concerns that I see already BEFORE health care reform. Right now, my peers in healthcare complain that Medicare only pays 25 cents on the dollar and that Medicaid only pays 12.5 cents on the dollar of healthcare charges and that it is a difficult job to set compensation for 1700 angry doctors in one healthcare organization. If we have angry doctors now, and government programs are not paying the true cost of healthcare now, what will happen with forced insurance coverage? Will there be enough doctors who want to work under conditions of very limited compensation? Will there be enough healthcare organizations that will financially survive to provide healthcare services?

We have all heard about the penalty tax for not purchasing health insurance; it starts at $95 in 2014 and goes up to $695 in 2016 or 2.5% of your taxable income, whichever is greater, and it is to be paid on your income tax return. Much has to be determined yet, on how to account for health insurance coverage. Can you imagine what that will do to income tax return information reporting? Perhaps a dependent deduction will only be granted the parent who provides health insurance? Tracking compliance will involve your personal income tax return and access to health care. If you go to the hospital for emergency care and you don’t have health insurance coverage, will hospitals be required to report you to the IRS for noncompliance?

There are a lot of questions on how this health care reform will be implemented, and subsequent blogs will explain what is currently known and written into law. The most important concept though is that the individual is the responsible party for purchasing health insurance.