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Paying the Healthcare Penalty Doesn’t Equal Coverage

Roughly 2-million people have signed up for coverage through the Health Insurance Marketplace. Those who don’t have some sort of “minimum essential coverage” in place by March 31, 2014, will face a penalty under the Affordable Health Care law.

According to healthcare.gov, emergency care for those who are uninsured can be very expensive and ends up costing the rest of the population a lot of money. The penalty for lack of coverage is being imposed to “encourage” everyone to obtain coverage for themselves.

The most interesting fact to keep in mind when considering whether or not to abide by the new Affordable Healthcare Law in terms of acquiring your own insurance plan is that paying the penalty does NOT equal coverage. The penalty is equivalent to a fine for not following the law. You will be charged the particular fine under the specifications of the Affordable Healthcare Act and, if you or a family member is uninsured and needs to seek medical care, you will be responsible for 100% of the costs associated with the care.

An easy-to-read and understand explainer is posted in blog form at the healthcare.gov website. It outlines the fee schedule for the penalty each year, starting with 2014, and answers questions about exemptions, what to do if you don’t believe you can afford it, how it is collected and so forth.

For quick reference, here’s the fee schedule (it’s the greater of the two):

  • 2014: $95/person and $47.50/child under 18. The maximum penalty per family using this method is $285 OR 1% of your yearly household income. The maximum penalty is the national average yearly premium for a bronze plan.
  • 2015: $325 per person OR 2% of your yearly household income.
  • 2016: $695 per person OR 2.5% of your yearly household income.

After 2016, the rates will be adjusted for inflation.

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