Consumers who cannot afford to buy major medical coverage, or simply do not want to do so, can apply for exemptions from the new “individual shared responsibility payment” requirements.
Officials at the Centers for Medicare & Medicaid Services explain the Patient Protection and Affordable Care Act individual mandate exemption process in a guide aimed at “in-person assisters” — people who help consumers sign up for public exchange plan coverage and use the coverage.
PPACA requires many people with incomes over a certain level to have “minimum essential coverage” or else pay a penalty for each month in which they lack MEC.
In practice, for 2014, most of the affected people who earn enough to be subject to the penalty will pay an amount equal to 1 percent of income, ranging from a minimum of $95 per adult and $47.50 per child for the full year, according to the Tax Policy Center.
The 2014 annual maximum penalty will be $3,600 (the national average cost of bronze-level exchange coverage) per affected adult and $1,900 per affected child.
PPACA caps the penalty for large families.
PPACA indexes the penalty amounts for inflation.
In 2016, the annual minimum will rise to $695 per adult and $347.50 per child. The maximum will rise to $4,045 per adult and to $2,135 per child.
In 2014, a single, uninsured, childless adult with an income of $60,000 might owe a penalty of $499. A single, childless adult with an income of $375,000 might owe the $3,600 2014 maximum penalty.
In the guide, CMS officials list the many types of penalty exemptions included in PPACA, such as exemptions for members of federally recognized Native American tribes; exemptions for people who have short gaps in coverage; and people who cannot find coverage that meets federal affordability standards.