Individual Mandate and Related Information Requirements under PPACA

David Newman
Specialist in Health Care Financing

This report describes the individual mandate under Section 1501 and Section 10106 of the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148), as amended by Section 1002 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152). Hereinafter, “PPACA” will refer to PPACA as amended by the reconciliation act and other laws. In addition, PPACA includes several reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate, as well as other related information about their health insurance. These requirements are also described in this report.

Beginning in 2014, PPACA requires individuals to maintain health insurance, with some exceptions. Most individuals will be required to maintain minimum essential coverage, which includes eligible employer coverage, individual coverage, grandfathered plans, and federal programs such as Medicare and Medicaid, among others. Those who do not maintain minimum essential coverage, and who are not exempt from the mandate, will be required to pay a penalty for noncompliance.


Date of Report: August 22, 2011
Number of Pages: 15
Order Number: R41331
Price: $29.95

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