Buy Insurance or Go to Jail?

By Lindsey Ellerson

Sep 25, 2009 6:43pm

ABC News' Teddy Davis reports:

The debate over whether the federal government should require all Americans to carry health insurance is heating up. The latest spark is a letter that Thomas Barthold, the chief of staff to the nonpartisan Joint Committee on Taxation, sent Thursday to Sen. John Ensign, R-Nev. Given that the health-care bill written by Finance Committee Chairman Max Baucus contains a $1,900 fee (or excise tax) for not buying health insurance, Ensign wanted to know what would happen if an American didn't pay the penalty. In a handwritten letter, Barthold told Ensign that under an existing provision of the Internal Revenue Code, willful failure to pay a fine can result in being charged with a misdemeanor which could carry a penalty of up to $25,000, or up to a year in jail, or both. The handwritten letter was a follow-up to an answer that Barthold gave Ensign during Thursday's mark-up of the Baucus bill. Barthold felt that he was not as thorough during the hearing as he could be after considering the Internal Revenue Code. During last year's campaign, then-Sen. Barack Obama, D-Ill., opposed an individual mandate. In fact, he clashed repeatedly with Sen. Hillary Clinton, D-N.Y., his future Secretary of State, on this issue. Since becoming president, however, he has switched his stance and now shares Clinton's view that an individual mandate is necessary in order to achieve new federal protections for individuals with pre-existing conditions. Pointing to experience at the state level, the insurance industry and other health-care experts persuaded Obama that insurers could not go along with a guanteed issue policy without knowing that all adults would be forced into the system. Insurers say that if you have guaranteed issue — which means no discrimination on the basis of pre-existing conditions — without an individual mandate, people will wait until they become sick to buy insurance and the system will fail due to a lack of risk sharing. Advocates of an individual mandate say that a requirement to buy insurance is essential because everyone is currently paying a "hidden tax" when people show up in the emergency room without insurance. (Under existing law, emergency rooms are required to treat urgent care matters without regard to ability to pay. If the patient cannot afford the bill, those costs are then passed to the government or people who have insurance in the form of higher prices). When considering the possible jail penalty, it should be noted that President Obama envisions an individual mandate being structured with some sort of hardship exemption. The Baucus health-care bill being considered by the Senate Finance Committee would exempt individuals who meet a government defined "unable to pay definition". There would also be an exemption for people whose religion conflicts with the mandate. Despite the fact that there is broad support for an individual mandate among Democratic politicians, the insurance industry, many experts, and even a few Republicans, Barthold's letter potentially hands the GOP a big new weapon in the fight against Democratic efforts to overhaul the nation's health-care system. View Barthold's letter to Ensign by clicking HERE. It was scanned by Ensign's Senate office and provided to ABC News. The accuracy of its contents was confirmed by the nonpartisan Joint Committee on Taxation.

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