House Republicans said Thursday that the Obama administration has left a giant loophole in its own individual mandate requiring all Americans to obtain health care coverage, saying a vaguely worded "hardship" exception announced last week will let millions of Americans duck the law.
The administration brushed aside the criticism, saying there has always been a hardship exemption for people who can show they cannot afford health care plans.
But Republicans said the provision, one of a number of exemptions listed on the application Americans must fill out to be insulated from the mandate's penalties, could end up wrecking the economics underlying the Affordable Care Act.
"The president's always claimed that getting rid of the individual mandate is tantamount to gutting Obamacare, yet the White House quietly added a new hardship exemption — for essentially everyone — and it seems that they're hoping that no one will notice," said House Speaker John A. Boehner, Ohio Republican. "This is a huge public policy decision that could affect millions of Americans."
Republicans said it was particularly stunning that the administration created such a broad exemption at a time when President Obama has vowed to veto a House bill that would cancel the individual mandate altogether. That bill is due for a vote Friday.
Exemption 14 reads: "You experienced another hardship in obtaining health insurance." The form urges applicants to "please submit documentation if possible."
The exemption apparently was added late last year, but critics noticed it just this week.
The Health and Human Services Department said it included the category on its form to account for "unique circumstances" that were not anticipated by other categories.
"The Affordable Care Act requires people who can afford insurance to buy it, so that their medical bills are not passed on to the rest of us, which drives up health care costs for everyone," HHS spokeswoman Joanne Peters said. "This form, which was published last December, allows a limited number of individuals who are facing hardship to apply for an exception. This exception also makes it easier to find insurance by allowing those individuals to access catastrophic-level plans."
The individual mandate was put into place to try to force those without insurance to get coverage — particularly younger, healthier adults who often think they don't need it.
The designers of Obamacare are counting on those Americans to pay into the system, thus subsidizing the costs for older, sicker patients who cannot be denied coverage under the law.
The Supreme Court in 2012 upheld the individual mandate as an appropriate use of Congress' taxing power.
Those who don't prove they have coverage by March 31 will face a penalty in the first year of either $95 or 1 percent of their applicable income. The penalty is scheduled to rise in subsequent years.
All sides are waiting to see how many have enrolled in Obamacare exchanges by the March 31 deadline.
Republicans say the ambiguity of the new exemption allows millions of Americans to duck the law and the penalty.
"The Obama administration once again tried to sneak through a unilateral change to Obamacare which essentially allows anyone who has experienced a hardship in obtaining health insurance to opt out of the individual mandate tax without requiring documentation," said House Majority Leader Eric Cantor, Virginia Republican.
Also this month, the Obama administration let Americans extend their bare-bones health care plans through 2016, even if the policies do not comply with the law's standards.
The move built on a one-year extension that the White House announced in November as it tried to quell a political backlash from Americans who received cancellation notices from their insurers.
However, the rule lets state insurance commissioners decide whether to allow the option, and policyholders must submit their cancellation notices with their hardship applications.
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