As the emphasis of the Affordable Care Act shifts from open enrollment to tax penalties paid by those Americans who chose to not get enrolled in 2014, the political debate is swinging to criticize the small penalties for not having coverage.

As quoted in The Hill on Feb. 10, Senate Majority Leader Mitch McConnell (R-Kentucky) was quoted criticizing the individual responsibility penalty. “If you don’t have health insurance, Obamacare has a tax for that, too,” McConnell said.

While ACA criticism is to be expected and respected, it’s important to remember that for too long private employers and individuals have paid a tax that wasn’t collected by the IRS. Instead, they paid approximately 7.6% more for health insurance premiums to cover the cost of medical procedures, since the uninsured received treatment from hospitals and medical facilities. These dollars were not redistributed by a governmental agency subject to its own criticism; instead we paid more to cover the losses of those who, due to financial circumstances, medical history or personal choice, were without coverage.

I admit, I’m not a fan of the entirely-too-small individual penalty — in an ideal world, it would be considerably higher. I have no desire to “punish” through a tax, but we need to create some form of accountability. We have to open our eyes and accept that not having coverage is, today (in light of the ACA’s market reforms), either an intentional or negligent decision that affects us all.

In our offices last April and May, our agents had people show up wanting to “buy some of that Obamacare.” We had to explain that the annual enrollment period ended March 31 (it ends this Sunday for the 2015 AEP) and they couldn’t enroll again until the fall unless they had some special enrollment event.

“Well I didn’t know it ended,” they’d say in a huff, frustration undeniable.

“There was a lot on the news about it ending … we were trying to tell everyone about the deadline coming up,” was the best meek reply we could muster.

The responsible course

Once we pointed out that the end of annual enrollment through the marketplace was that story between the disappearance of Malaysia Airlines Flight 370 (which they’d heard about) and the split of rocker Chris Martin and actor Gwyneth Paltrow (which nearly everyone remembered, too), they’d stomp out, mumbling about getting screwed again.

Now this year, when their tax refund checks are a little short of expectations, it’ll be the blame game again, and Sen. McConnell’s comment will feed that frustration.

But, it’s time to accept that the only responsible course is to be covered, and blaming the government is not the answer. It is a choice that we all make, and must accept the responsibilities that go within living in a responsible society.

Smith is vice president, health & welfare benefits, at Ebenconcepts in Fayetteville, N.C. Reach him at

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