Individuals who would have to pay more than 9.5 percent of their income for their employer-sponsored individual health plan would be eligible for subsidies through the online health insurance exchanges. But the rule clarifies this only pertains to individual plans, not to family plans, which are likely to cost more.
Consumer groups have expressed concerns this could lead to families being unable to afford coverage for children and spouses and ineligible for subsidies, according to a report by The Hill.
Americans whose incomes fall below 133 percent of the federal poverty line — and who live in a state that will not expand Medicaid — are also exempt from the individual mandate’s penalty.
All individuals must obtain health insurance in 2014 or pay a “shared responsibility payment,” unless they are members of a protected category of individuals, including those who demonstrate certain hardships or religious opposition to the mandate. Citing a Congressional Budget Office estimate, CMS said less than 2 percent of Americans will owe the penalty.
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