January 22, 2013

Regulations on individual mandate expected soon

From:  Healthwatch/The Hill’s Healthcare blog

By Sam Baker

The White House budget office is reviewing new rules to implement benefit requirements in President Obama’s signature healthcare law.

The regulation could be issued this month — a review from the Office of Management and Budget (OMB) is typically one of the last steps before regulations are published.

The rules recently submitted to OMB deal with exemptions from the rules for “minimum essential coverage” — the standards that coverage has to meet to satisfy the healthcare law’s individual mandate, which requires most taxpayers to either buy health insurance or pay a penalty.

But there are exceptions: people who don’t make enough money to pay taxes are not subject to the mandate, and there are religious exemptions as well. Those who would have to spend more than 8 percent of their income on health insurance are also exempt.

Those exemptions are part of the reason some policy analysts think the mandate is too weak — that it won’t be effective at getting young, healthy people into the insurance system, to offset the costs of covering older, sicker patients.

A notice posted on OMB’s website says the pending regulation will deal with the process for verifying whether taxpayers are able to buy employer-based healthcare and determining whether they’re eligible for federal subsidies to help buy private insurance.

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