Final regulations now provide guidance on what coverage individuals must maintain to meet health care reform’s individual mandate. Health care reform generally requires all individuals to have affordable health coverage, qualify for an exemption, or pay a penalty when filing their tax return. The IRS issued final regulations on the individual mandate.
The final rules mostly track previous proposed guidance, with the following changes and/or confirmations.
Coverage must be affordable for an employee. In determining affordability,
The guidance also confirms that Medicaid coverage for needy individuals (not full Medicare) is generally not minimum essential coverage, and an individual can claim a hardship exemption from the individual mandate only for the limited reasons identified by the IRS. Other hardship exemption claims will not be considered.
The final regulations largely follow existing guidance, and individuals should be ready to maintain health coverage or pay a penalty on their tax return.