Senate Bill Fines People Refusing Health Coverage

In this file photo, patients wait at the Emergency Room entrance at Riverside County Regional...

In this file photo, patients wait at the Emergency Room entrance at Riverside County Regional Medical Ctr in Moreno Valley, just outside Los Angeles. Senate Democrats today are unveiling a new non-partisan analysis of their health care reform plan that dramatically cuts the estimated cost -- and that includes a ?public option? for health insurance.

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Americans who refuse to buy affordable medical coverage could be hit with fines of more than $1,000 under a health care overhaul bill unveiled Thursday by key Senate Democrats looking to fulfill President Barack Obama's top domestic priority.

The Congressional Budget Office estimated the fines will raise around $36 billion over 10 years. Senate aides said the penalties would be modeled on the approach taken by Massachusetts, which now imposes a fine of about $1,000 a year on individuals who refuse to get coverage. Under the federal legislation, families would pay higher penalties than individuals.

In a revamped health care system envisioned by lawmakers, people would be required to carry health insurance just like motorists must get auto coverage now. The government would provide subsidies for the poor and many middle-class families, but those who still refuse to sign up would face penalties.

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Called "shared responsibility payments," the fines would be set at least at half the cost of basic medical coverage, according to the legislation. The goal is to nudge people to sign up for coverage when they are healthy, not wait until they get sick.

In 2008, employer-provided coverage averaged $12,680 a year for a family plan, and $4,704 for individual coverage, according to the Kaiser Family Foundation's annual survey. Senate aides, who spoke on condition of anonymity because they were not authorized to speak publicly, said the cost of the federal plan would be lower but declined to provide specifics.

The legislation would exempt certain hardship cases from fines. The fines would be collected through the income tax system.

The new proposals were released as Congress neared the end of a weeklong July 4 break, with lawmakers expected to quickly take up health care legislation when they return to Washington. With deepening divisions along partisan and ideological lines, the complex legislation faces an uncertain future.