Require most U.S. citizens and legal residents to have health insurance. Create state-based American
Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-
sharing credits available to individuals/families with income between 133-400% of the federal poverty
level (the poverty level is $19,530 for a family of three in 2013) and create separate Exchanges through
which small businesses can purchase coverage. Require employers to pay penalties for employees who
receive tax credits for health insurance through an Exchange, with exceptions for small employers.

Impose new regulations on health plans in the Exchanges and in the individual and small group markets Expand Medicaid to 133% of the federal poverty level.

Require U.S. citizens and legal residents to have qualifying health coverage. Those without coverage
pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085)
per family or 2.5% of household income. The penalty will be phased-in according to the following
schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014,
2.0% of taxable income in 2015, and 2.5% of taxable income in 2016. Beginning after 2016, the penalty
will be increased annually by the cost-of-living adjustment. Exemptions will be granted for financial
hardship, religious objections, American Indians, those without coverage for less than three months,
undocumented immigrants, incarcerated individuals, those for whom the lowest cost plan option
exceeds 8% of an individual’s income, and those with incomes below the tax filing threshold (in 2009
the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).
Assess employers with 50 or more full-time employees that do not offer coverage and have at least one
full-time employee who receives a premium tax credit a fee of $2,000 per full-time employee, excluding
the first 30 employees from the assessment. Employers with 50 or more full-time employees that offer
coverage but have at least one full-time employee receiving a premium tax credit, will pay the lesser of
$3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding
the first 30employees from the assessment. (Effective January
Assess employers with 50 or more full-time employees that do not offer coverage and have at least one
full-time employee who receives a premium tax credit a fee of $2,000 per full-time employee, excluding
the first 30 employees from the assessment. Employers with 50 or more full-time employees that offer
coverage but have at least one full-time employee receiving a premium tax credit, will pay the lesser of
$3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding
the first 30 employees from the assessment. (Effective January 1, 2014)
•Exempt employers with up to 50 full-time employees from any of the above
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