Q: If I pay the tax for not purchasing health insurance, does that buy me an insurance policy?
A: No. You’re not buying insurance; you’re paying a tax that helps keep the health care system afloat. As Princeton economist Uwe Reinhardt explains: “The penalty approximates the cost” that individuals who choose not to purchase insurance “might impose as a group, on hospitals” when they “are treated and released with unpaid bills.”
But when you’re uninsured, you have no coverage – regardless of whether you end up having to pay the penalty or not. If you end up in an emergency room while uninsured, they’re required by law (EMTALA, which is decades older than the ACA) to assess your condition and stabilize you if stabilization is needed. That means they won’t send you back onto the street with a gaping wound, or in the middle of a heart attack.
But hospitals and doctors are not required to provide care beyond emergency stabilization if you have no ability to pay for that care. So you’d be out of luck if you were to end up with a chronic condition that requires ongoing care.
The good news is that open enrollment for health insurance comes around again every year, so you’ll have another opportunity to enroll in a health plan for the coming year.