Should the IRS be removed from its health-care role?

2013-07-22T00:00:00Z Should the IRS be removed from its health-care role?William Rice Arizona Daily Star
July 22, 2013 12:00 am  • 

WASHINGTON - For a law whose admirable goal is to ensure better health care at lower cost for all Americans, the Affordable Care Act has come under remarkably varied and persistent attack.

The latest volley concerns the obscure issue of how to apply a penalty on individuals and businesses that fail to obtain health insurance, and who thereby put all the rest of us on the hook for big medical bills.

This penalty - which is intended to encourage the classic conservative value of personal responsibility - will be collected as part of annual tax filings, a reasonable and efficient method that's only objectionable to those who's real objection is to the whole concept of reform.

From a purely technical standpoint, the IRS is the appropriate agency to collect these payments, since the Supreme Court has declared the penalty assessed on individuals is a tax. And it certainly can be viewed that way, since the money raised will help offset the public cost of uninsured care. But even if not a tax, the uninsured penalty joins dozens of other non-tax payments the federal government, states and localities routinely collect without controversy on their tax forms, from underpayment penalties to presidential campaign contributions to camping fees.

Tax collectors are never popular, and the IRS is no exception. The extra scrutiny many conservative groups seeking nonprofit status were subjected to in recent years, though many liberal organizations were as well, has raised legitimate concerns that are being addressed.

That apparent IRS administrative error has no bearing on the agency's ability to fairly collect penalties from individuals and businesses trying to duck their health-care responsibilities.

No one will go to jail for not buying health insurance. In fact, the ACA specifically softens the enforcement powers of the IRS in this area, forbidding the agency to seek criminal penalties or obtain liens or garnishee wages in pursuit of the penalty on uninsured individuals. And for reasons ranging from too little income to religious belief and practice, individuals can obtain an exemption from the requirement to obtain insurance and thus from any penalties.

Most uninsured people want to be insured. The problem for them has not been a lack of coercion, but a lack of opportunity.

What's ironic about conservative opposition to IRS involvement in administering the Affordable Care Act is that it's necessary only because the basis of the law is individual, rather than community, responsibility.

The individual mandate to obtain health insurance originated with the conservative Heritage Foundation and was endorsed by former conservative House Speaker Newt Gingrich.

As important a step toward universal health-care coverage as the ACA represents, the simpler, more equitable and more efficient solution would have been Medicare for all.

No: It's logical and appropriate

Editor's note

Every Monday we offer pro/con pieces from the McClatchy-Tribune News Service to give readers a broad view of issues.

William Rice is a policy consultant with Americans for Democratic Action.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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