Dr. Klauer: So Mike, is it fair to say that the IRS has been given the charge and also the authority to implement the financial aspects of the Affordable Care Act?
Explore This IssueACEP Now: Vol 33 – No 01 – January 2014
Dr. Granovsky: Yes, that’s correct, although perhaps not all the tools required to do it.
Dr. Klauer: Do you think they’ve been given more latitude with this than with standard implementation of the tax system and tax code, or less?
Dr. Granovsky: The IRS has a very narrow and defined role as far as the way they can recoup any penalties.
Dr. Taylor: I wanted to ask a question. How much penalty does this group believe would be required to actually force people to purchase insurance?
Dr. Cirillo: I’ll chime in.
I think the penalties on both the individual and the employer side are so unequal to the actual ask to pay for insurance that I don’t they’re going to make any difference to people; I think people will accept the penalty. I think Mike’s right: the IRS has very limited tools in their toolbox to go get money from individuals.
Even with their subsidies, as Todd said, there’s still going to be this $6,350 for an individual and $12,700 deductible out-of-pocket cost for a family, and I don’t see that people are going to be able to afford either of those. And the only way you’d actually be able to make them buy insurance is to make the penalty almost as bad, or as painful, as the cost of the insurance.
One of the reasons why the employer mandate was delayed a year is I think the administration was going to see a number of companies opt to take the penalty and drop insurance for their employees.
Bryn Nelson, PhD, is a medical journalist based in Seattle.