Obamacare sign-up deadline delayed. Is the mandate effectively gone?

The long-touted March 31 deadline to enroll in health coverage via the federal online marketplace is effectively gone, following a decision by the Obama administration to allow Americans more time to enroll.

The decision, scheduled for announcement Wednesday, will give people until mid-April to sign up for insurance. All they need do is check off a box on HealthCare.gov indicating that they tried to enroll by March 31. The government will not check to see if people are telling the truth. The decision to allow more sign-up time was driven by an anticipated last-minute surge in enrollments, which could leave people unable to finish the process, The Washington Post reports.

President Obama has insisted repeatedly that the March 31 deadline would not slip. Insurance companies need to know soon who has enrolled, so they can set rates for 2015, administration officials say. The insurers' deadline is fast approaching: between May 27 and June 27. What’s more, any suggestion that the March 31 deadline might slip would only encourage procrastination.

Now the March 31 deadline has grown soft. And that, plus the advertising of 14 “hardship exemptions” to the individual mandate to buy insurance, has added to the sense that the mandate is all but theoretical.

“What individual mandate?” says the headline on a blog post Monday by health policy expert Bob Laszewski. “It is looking more and more like the Obama administration will not enforce the individual mandate.”

The 14 exemptions are wide-ranging. You are exempt if you have filed for bankruptcy in the past six months. Or if you received a shut-off notice from a utility. Or if you recently experienced domestic violence. The final exemption seems to be a catchall: “You experienced another hardship in obtaining health insurance.”

The page on exemptions at HealthCare.gov also provides links to forms to apply for an exemption.

Last week, Mr. Obama advertised the exemptions in an interview with WebMD.com.

"What I think is important for people to understand is that if, in fact, they still can't afford it, there is a hardship exemption in the law,” the president said. “That means they may not be subject to a penalty. The penalty really applies to folks who clearly can afford health insurance but are choosing not to get it."

Another question on the mandate is how aggressively the Internal Revenue Service will enforce it. Starting next year, taxpayers will be asked on their returns if they have insurance, and if not, to pay a penalty – unless they have been granted an exemption. But like other aspects of tax returns, the information is taken on the honor system and only checked during an audit.

Ultimately, the administration is juggling competing imperatives. For Obamacare to be successful, it needs to enroll as many people as possible – most critically, young and healthy people whose premiums can help pay for the care of older, less healthy people.

But there’s also a political dimension. The administration is loath to see media coverage of people facing personal hardships who then get fined by the government for failing to buy health insurance. That's where the exemptions come in.

Still, politics is part of the picture no matter what. On Wednesday, Senate minority leader Mitch McConnell (R) of Kentucky slammed the administration after news broke it was allowing the March 31 deadline to slip.

The law has become “the legal equivalent of Swiss cheese,” Senator McConnell said.