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Health Care Insurance Individual Mandate Enforcement

Innovation Blurb: 
A Unique Strategy to Reduce Uninsurance

In 2008 and 2009, the Commonwealth of Massachusetts became the first state in the nation to implement and enforce an individual mandate on health insurance. Through coordination with the Department of Revenue, Massachusetts residents must submit proof of creditable health insurance coverage on their state tax returns, or face a penalty equal to the amount of their personal exemption. The system is specific in that it prorates the penalty based on the number of months uninsured, and is especially innovative in its efforts to ensure that the penalty does not disproportionately harm low-income community members. Residents with incomes under 150% of the federal poverty line are exempt from the tax penalty, and other residents may submit simple appeal forms. In a time when national health care reform is being seriously debated, experts and residents all over the country are looking to the examples set by Massachusetts Health Care Reform.

Their Description: 

The Act requires most adults 18 and over with access to affordable health insurance to obtain it. In 2009, individuals must be enrolled in health insurance policies that meet minimum creditable coverage standards defined in regulations adopted by the Commonwealth Health Insurance Connector Authority (the Connector). Individuals who are deemed able to afford health insurance but fail to comply are subject to penalties for each month of non-compliance in the tax year (provided that there is no penalty in the case of a lapse in coverage of 63 consecutive days or less). The penalties, which will be imposed through the individual’s personal income tax return, shall not exceed 50% of the minimum monthly insurance premium for which an individual would have qualified through the Connector.[1]


<p>MA Department of Revenue 617-887-MDOR</p>

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