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One of the most important and most controversial parts of the new health care law, the Patient Protection and Affordable Care Act as amendment by the reconciliation bill, is that it requires all U.S. residents to have insurance or pay a tax penalty. This is known as the "individual mandate," and although it is a Republican idea that has a long history of bipartisanship, both conservatives and progressives have recently focused their criticisms of the law on it.

In reality, it's quite nuanced. The idea of the law is that it will control costs and provide enough government assistance that insurance will be affordable for everyone and that the individual mandate penalty will not have to be used. It will give out billions in "affordability credits" and it includes an economic hardship exemption so that people who can't reasonably afford insurance under the new law won't have to pay the tax. Here's a detailed rundown of how the affordability and individual mandate provisions would work, including, to the extent possible, how much money people will be expected to pay for insurance under the new law.

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Not Much of a Mandate

March 25, 2010 - by Donny Shaw

Ezra Klein reminds us of a provision in the health care bill dating back to the Senate Finance Committee's work in October that is important, but largely forgotten. If you don't abide with the bill's requirement starting in 2014 that you have acceptable health coverage, you are supposed to pay a fine to the government. But, under the new bill, those who fail to get insurance and fail to pay the fine will pretty much get off scott free.

And what happens if you don't buy insurance and you don't pay the penalty? Well, not much. The law specifically says that no criminal action or liens can be imposed on people who don't pay the fine. If this actually leads to a world in which large numbers of people don't buy insurance and tell the IRS to stuff it, you could see that change. But for now, the penalties are low and the enforcement is non-existent.

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Opposed to Even Their Own Ideas

February 16, 2010 - by Donny Shaw

The requirement in the Democrats' health care bills that all individuals have some form of insurance coverage has become a prime target of Republican scorn. But, as NPR's Julie Rovner explains, the idea actually originated with Republicans and enjoyed broad bipartisan support until just recently.

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