The Supreme Court decision on the Affordable Care Act handed journalists something of a semantic dilemma. What do we call the sanction against people who do not buy the required health insurance? Is it a tax or a penalty? What should we call it in our stories?
In upholding the constitutionality of the law, Supreme Court Chief Justice John Roberts wrote that, “It is of course true that the Act describes the payment as a ‘penalty,’ not a ‘tax.’” But, he added: “The exaction the Affordable Care Act imposes on those without health insurance looks like a tax in many respects.”
Given Roberts’s opinion—and the fierce GOP effort to amplify that part of his ruling—it is hardly surprising that a new Quinnipiac poll last week found that 55 percent of the voters believe the sanction is a tax hike. Thirty-six percent said it was not.
Still, even Mitt Romney’s camp has shifted on this one. At first the candidate, who has his own history with a healthcare mandate in Massachusetts, did not believe that the sanction should be called a tax. Two days later Romney flip-flopped, declaring it a tax after all. The Obama administration, of course, prefers to call it a penalty, not a tax. “The law is clear, it’s called a penalty,” said the White House chief of staff, Jack Lew. The president’s press secretary, Jay Carney, argues, “It’s simply a fallacy to say that this is a broad-based tax.”
The operative words here may well be “broad-based.” In other words, the president’s people argue, it’s not a cost that applies to just about everyone, like income taxes, for example. Lew and Carney both argue that that the sanction is a penalty because only about one percent of the people who can afford insurance and choose not to get it will have to pay something. The Congressional Budget Office estimates that some 4 million people will be so affected, though the precise number won’t be known for years, since deciding whether to buy insurance or take the sanction will involve messy financial calculations for many families.
How does it work? The Affordable Care Act, on the grounds that the new system won’t work if too many citizens bypass health insurance, envisions some financial discomfort for those who don’t buy the required coverage. By 2016, when the phase-in is complete, the penalty will be the greater of a set amount—$695 for each uninsured adult in a family, and 347.50 for each child, up to $2,085, or a percentage of income—2.5 percent of family income, up to $12,500.
The Kaiser Family Foundation has a pretty good flow chart for figuring out what this will mean in dollars and cents for families of various incomes and situations as the law rolls into full effect between 2014 and 2016. In 2016, for example, a husband a wife with two kids and an income of, say, $70,000 would have to pay $2,085 (695 x 2 adults plus $347.50 for two kids). Last fall, meanwhile, a survey by Kaiser found that premiums for family coverage provided by employers averaged about $15,000.
Some families will decide that the risk of going bare is too great, and opt for coverage. Others may decide that taking the penalty is cheaper than paying a premium, and gamble on no coverage. Still others might qualify for government subsidies that diminish the financial burden. What people will do is a story for another day.
The question for journalists now is, if people opt out of insurance and instead decide to pay, what do we call the darn thing they are paying? It seems to me The Associated Press got it about right. A piece by Stephen Ohlemacher describing the limited ability of the IRS to actually collect monetary penalties from those who don’t buy insurance, referred to it as a “penalty—or tax.” Calling it a tax penalty or a penalty tax should do the trick.

Nobody in his or her right mind will buy health insurance in 2016.
Anyone with a functional cerebrum will pay the tax (or "penalty/tax") until somebody in his or her family get sicks and then he or she will buy insurance.
Obamacare is a stupid Gubmint boondoggle that will accomplish the precise opposite of its stated goals. It will cost gobs of money and it will, result in crappy care, and will reduce coverage rates.
#1 Posted by padikiller, CJR on Tue 17 Jul 2012 at 08:24 AM
It's a subsidy to the political entrepreneurs and other parasites who lobbied for and passed the legislation. To everyone else, it is tyranny. But all Good Journalists will call it a tax or a penalty as they genuflect, kiss the emperor's ring, and hail Our Infallible Black-Robed Deities.
#2 Posted by Dan A., CJR on Tue 17 Jul 2012 at 10:14 PM
You seem to think 98% of the population pays full price per person for their health insurance yet anyone working in a company of over 100 employees will have to purchase theirs from the company by monthly deductions as most do now. The poor need the Medicaid in part or full just to be able to see a doctor. The $12,000+ in three years could be raised as well as the price of insurance go down. Much is yet totally unknown. It also depends on whether one's single or has a family of 3 or more children under the age of 18. Also, if you are without insurance and fall down the stairs breaking your leg or you become sick, your cost will total much more than $12,000 that only the uninsured would be required to pay. The rest of us will pay only part or none at all depending on age, income and insurance policy.
If you consider this tyranny wait till you have a car accident, that totals your car and one or more others. You are at fault but you have to pay your own medical bills as a disabled worker with no insurance. Health insurance is not just to cover your medical bills tomorrow but to help you avoid getting ill in the first place. Check ups, shots and some tests may be free at the doctor's office but your insurance indirectly covers them since the doctors are paid for your health care. Besides you are just one of 325 million people in this society of ours and you must pay your part just like everyone else must if they can. Your selfishness tells me a lot about who you care for and it isn't many--hardly one from my view.
#3 Posted by trish, CJR on Wed 18 Jul 2012 at 12:35 AM