Individual Mandate and Related Information Requirements Under PPACA

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The Congressional Research Service (CRS) released a report detailing how the individual mandate, a provision in the federal health reform law, will work when it takes effect in 2014. The individual mandate is considered a very important part of the law because it ensures healthy people obtain coverage, which in turn helps spread risk and keep costs down. According to the report:

  • The ACA does grant exemptions from the individual mandate penalty if, for example, coverage is deemed unaffordable;
  • The law allows exemptions from the individual mandate for those with religious objections, in a health care sharing ministry, not legally present in the United States, or incarcerated;
  • The law sets forth reporting requirements to ensure the IRS knows who has obtained proper coverage, as well to make sure individuals know if the coverage they obtain meets the requirements for adequate coverage;
  • CRS also includes examples of how much an individual or family would pay if they did not obtain adequate coverage.