Health Care Insurance Individual Mandate Enforcement

In 2008 and 2009, the Commonwealth of Massachusetts became the first state in the nation to implement and enforce an individual mandate on health insurance. Through coordination with the Department of Revenue, Massachusetts residents must submit proof of creditable health insurance coverage on their state tax returns, or face a penalty equal to the amount of their personal exemption. The system is specific in that it prorates the penalty based on the number of months uninsured, and is especially innovative in its efforts to ensure that the penalty does not disproportionately harm low-income community members. Residents with incomes under 150% of the federal poverty line are exempt from the tax penalty, and other residents may submit simple appeal forms. In a time when national health care reform is being seriously debated, experts and residents all over the country are looking to the examples set by Massachusetts Health Care Reform.