Category Archives: Individual Health Plans

Alexander (Zach Gibson/Getty Images)

Politico (9/1),  The Hill (9/5)

“Repeal and Replace”

Ultimately, whether the individual mandate and the associated penalty remains intact or goes away depends on what Republicans in the Senate decide to do. The American Health Care Act, which passed the House of Representatives in early May, would not eliminate the individual mandate but rather would reduce the penalty to $0 effective immediately.

The mandate would eventually be replaced by a “continuous coverage incentive” that would provide for a 30% surcharge for late enrollees in the individual market. Basically, anyone with a coverage gap of 63 days or more in the previous 12 months would pay 30% more for the next 12 months, giving individuals an incentive to purchase and maintain health insurance.

The Senate is still working on its version of the bill, and while there were multiple reports that they were going to start over from scratch, we really don’t know what the bill will look like since it’s being crafted in private, hidden from the public and even from Democratic lawmakers. As the New York Times puts it, “they are coming up with the legislation behind closed doors without holding hearings, without consulting lawmakers who disagree with them and without engaging in any meaningful public debate.”

Whatever emerges out of the Senate, we still don’t know what, if anything, will end up happening. In the end, the House and Senate must agree and vote on a single version of the bill to send to the President’s desk, and right now there’s still a lot of disagreement. Top that with the fact that President Trump is now saying that the House version of the bill is “mean,” and we really don’t know what to expect.