Former President Barack Obama signed an order into law back in March 2010, which later became known as Obamacare. He did so with the hope that it would revolutionize the way Americans handled their healthcare. However, if Obamacare was to ever survive, it required a large number of healthy individuals to sign-up for healthcare.
To “persuade” healthy individuals to sign up for plans, Obamacare included a mandate. This required everyone in the United States who didn’t have other healthcare to sign up for healthcare on either the state or government exchanges… or else.
This meant that if you had healthcare from your employer, you were covered. If you signed yourself and/or your family up on the exchanges, you were covered. But if you currently had no health insurance, and did not have an employer that offered it to you, then you either had to sign up for healthcare on the exchanges or face a financial penalty. In 2016, the penalty for not having health insurance was $695 per adult, $347.50 per child, OR 2.5% of your adjusted gross income (whichever number was higher), with a maximum amount per family of $2,085.
Now, on its face, that amount might make you think, “Geesh, I better get health insurance.” The sad reality of the mandate, though, was that it wasn’t punishing enough. Let’s take a healthy individual, who hypothetically needs to pay $500 a month in health insurance premiums. Many of them would rather just pay the $695 one-time penalty than fork over $6,000 for health insurance premiums in a given year.
The end result was tens of millions of Americans still declining to sign up for Obamacare, which meant the amount of money in the health insurance pool was far lower than what was predicted. To compensate, health care providers increased the costs for existing exchange owners, sometimes as much as 115% year over year. Hanging by a thread, the law needed Hillary Clinton to be elected president in order to survive. Instead, it was given Donald Trump.
Goodbye Obamacare Mandate
It may feel like Donald Trump has been president for four months and not four weeks. However, if you can think all the way back to President Trump’s first executive order, it was one to remove the enforcement of the Obamacare mandate. To put it simply, President Trump ordered the U.S. government to defer to the individual, rather than the government, should a dispute arise regarding the enforcement of the mandate. This didn’t really mean much the day he signed it because its implementation was unclear. However, last week the IRS put out a statement that said, “If you don’t answer the healthcare question on your tax return, we will still accept your return.”
So, Line 61 of your 1040 tax return will ask if you had healthcare coverage for more than 9 months in the 2016 tax year. Before this change in policy, you had three options to answer the question:
- You can check YES, and show proof of coverage
- You can check NO, and expect the penalty amount above to be included in your return
- You can check EXEMPT, and show proof of exemption
Now, there’s a fourth option for every US taxpayer:
- Naa Na Naa Na Naa Naa, I’ll never tell you
To be clear here, there is no guarantee that if you leave the question unanswered, the IRS will simply look the other way. The IRS has not explicitly said they will be avoiding all Obamacare penalties for the 2016 tax year. However, considering they’ve decided to allow taxpayers to leave this question blank, it’s highly unlikely that they plan to create more work for themselves and audit individuals who choose to avoid the question.
Thus, in one stroke of the pen, the mandate is done. This all-but-means that Obamacare has been effectively killed, and the need for a replacement healthcare plan is of great urgency.
What Will a Trumpcare Mandate Look Like?
Knowing that the end is near for Obamacare (you might say it’s already here), the next logical question is: Will there be a Trumpcare mandate and, if so, what will it look like?
Well, I’m here to tell you that a gentleman by the name of Tom Price proposed a conservative healthcare plan back in 2015…and wouldn’t you know it, he’s just been confirmed as the new Health and Human Services Secretary. Without getting into specific detail about the entirety of the plan, I’d like to focus squarely on his idea for how to make a mandate work in the future.
The crux of Obamacare, and the part that Republicans have always hated, was that it forced people to buy health insurance, even if they didn’t want it. But you see from the text above that the only way a national healthcare plan would work is if everyone contributed, healthy or otherwise. So, how can a Republican plan provide enough money so that those with Obamacare do not lose coverage AND people that don’t want health insurance don’t have to buy it?
Tom Price proposed two main ideas:
- This should not be national health care. It should be private and sold across state lines, which is expected to increase competition and lower prices.
- Pre-existing conditions should be included, so long as the consumer has had 18 consecutive months of healthcare coverage. If someone without healthcare suddenly gets sick and tries to buy coverage, they can be charged appropriate rates based on a previous medical condition. Also, their current healthcare costs can potentially be increased by 50% annually, for up to three years.
The best analogy I can think of is comparing this idea to your auto insurance policy. If you’ve just signed up for auto insurance and get into a big accident, your insurance provider is likely to increase your rates substantially. However, if you’ve been with your auto insurance carrier for years, you likely have small (or large) accident forgiveness, so your rates are not increased. Similarly, if you’re healthy and have avoided buying health insurance for years and then get sick, don’t expect to walk through the door with a low-cost health insurance policy.
Now, this is not to say that the healthcare proposal Congressional Republicans put forward will include a mandate specifically like the one above. It is simply an idea on how to go about getting people to pay for health insurance, without forcing them to pay for health insurance. You can bet any plan that we see proposed in the next few weeks will receive extreme scrutiny from tens of millions of Americans, so the benefits and drawbacks will be widely known.
Make sure that when the dust settles, you’ve done your research on whatever 2018 health insurance looks like, and do the best for you and your family. Something tells me you won’t be short of options.
Updated February 25, 2017 and originally published February 23, 2017.