WASHINGTON — Object to abortion? You may be able to get an exemption from the Affordable Care Act tax penalty for people who don’t get health insurance.
The Centers for Medicare and Medicaid Services announced final rules Monday for the ACA’s health insurance marketplaces, and expanded exemptions were part of the package.
Last year’s GOP tax bill repealed the health law’s unpopular requirement to carry health insurance or risk fines from the IRS — but that doesn’t happen until next year.
Officials said expanded hardship exemptions will go into effect immediately. People who object to abortion can get an exemption if all available health plans in their area cover the procedure.
There’s also an exemption for people living in communities that only have one participating ACA insurer, about half of U.S. counties. In 2016 about 6.5 million people paid fines for being uninsured, averaging $470. Penalties have gone up since then.
Also on Monday, the administration announced new rules for the ACA marketplaces in 2019, including more options for states to redesign benefits within 10 broad categories required by the health law. Consumer advocates say this could whittle away at comprehensive coverage for people with serious health problems.
But the administration is under pressure from Republican-led states to reduce the cost of health insurance for consumers buying their own policies. One of the ways to do that is by cutting back on benefits.
Customers who don’t qualify for subsidies under the Obama-era health law have faced several rounds of steep premium increases. Republican attempts to entirely repeal the law fell short last year, in one of the biggest defeats for President Donald Trump.
The coverage exemption for abortion objectors is on top of financial hardship exemptions traditionally offered under the ACA. In previous years about twice as many people have been able to get exemptions as paid the fines. The Trump administration’s action broadens the list of reasons for an exemption, but it’s still unclear how many people will avail themselves of the new options. Individual consumers must apply through HealthCare.gov.
Medicare and Medicaid administrator Seema Verma said the exemption for abortion objectors provides “pro-life Americans” with relief if they are living in an area where the only available ACA plan covers abortion. About half the states already forbid ACA plans from covering abortion, so it’s also uncertain how many consumers would qualify for the new exemption.
Religious conservatives are a core constituency for the Trump administration.