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Life Health > Health Insurance > Health Insurance

Putting the 'individual' in mandate

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Recently, the courts allowed a lawsuit questioning the constitutionality of the PPACA’s individual mandate to move forward. In the initial hearing, the government argued the mandate is nothing more than a tax – something that they vehemently denied during the “debate” in Congress. Expediency often trumps the facts in Washington, D.C., but the judge wasn’t buying the government’s argument.

Everyone is aware of that lawsuit, but there are individuals taking up the case as well. Matt Sissell is an eight-year veteran of the Iowa National Guard and describes himself as “a healthy young man fresh out of art school.”

Sissell is starting an art school of his own and says, “As a business person, I intend to cover my own medical expenses, and I want the freedom and flexibility to do my own budgeting – including setting money aside for medical needs.”

Sissell prefers individual responsibility to an individual mandate, so he has filed a federal lawsuit challenging the constitutionality of the PPACA’s individual mandate.

In Massachusetts, often cited as a bellwether for federalized health care, Mike Merlina installs glass for a family-owned business on the North Shore. The company has seven employees and doesn’t provide health insurance. Merlina was covered on his wife’s employer-sponsored plan, but she is in between jobs. The family budget is pretty tight, and with his wife out of work, their basic monthly expenses exceed Merlina’s take-home pay.

Last year, Merlina paid a $400 fine for not having insurance. This year, the Commonwealth has fined him $2,000.

“I’m a hard-working guy who can’t afford $800 a month for insurance or the $2,000 penalty for not having it, and nobody seems to get it,” Merlina says.

He has agreed to sign a document saying he is responsible for his health care costs if anything happens. Massachusetts won’t permit that, so Merlina, acting as his own counsel to make the costs affordable, has filed a lawsuit in Middlesex County Court.

Merlina sums up the frustration of many: “It’s impossible to me how they could miss where I am coming from. I am hanging by a thread, and I feel like I am not being heard at all.”

Check out more blog entries from David Saltzman.


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