BOSTON—Come Jan. 1, Massachusetts residents who still haven't signed up for health insurance will start racking up fines on a monthly basis.
Those penalties may be up to half of the monthly premiums for the least expensive health care plan available, although the exact amount of the fines is expected to be announced as soon as this week.
That's on top of the loss of the $219 personal tax exemption for anyone not insured by the end of December.
The fines are part of an increasingly more aggressive approach written into the state's landmark health care law designed to pressure Massachusetts residents into getting insurance. The law, intended to create near-universal coverage in the state, was approved by lawmakers and signed by former Gov. Mitt Romney in 2006.
Even those residents who already have insurance will see some changes when they file their taxes this year.
Everyone, including those insured through their employers, will be required to fill out a new tax form proving they have insurance to avoid paying penalties.
That form -- dubbed 1099-HC -- will require taxpayers to provide the name of their insurer and their subscriber number.
The form will also allow individuals and families to claim an exemption to the law -- either for religious or hardship reasons. Those claiming exemptions will be asked to provide supporting information to back up their claim.
Those who still refuse to get insurance even after being deemed able to afford it, will see the penalties add up quickly.
The monthly premium for the least expensive health care plan -- a so-called "bronze level" plan with no prescription drug coverage -- for a 37-year-old male living in Boston is $196.
Under the law, the penalty for not getting insurance could be up to half that cost -- about $98 a month, or $1,176 for the year.
The actual penalty will be determined by the Department of Revenue that is charged with coming up with the fine structure.
A spokesman for the department said the goal is to keep the fines as simple and clear as possible so everyone knows the cost of not getting insurance.
"It will be a dollar amount so it will be clear," department spokesman Bob Bliss said. "We will try to keep it as simple as possible so people can understand it."
Bliss said the department launched an outreach campaign this year to alert people to the new law, including mailing postcards and distributing flyers to taxpayers, setting up a web site and creating a video tutorial to walk taxpayers through the new form.
Health care advocates have also worked hard canvassing neighborhoods and teaching people about the law which provides free or subsidized care for people making up to three times the federal poverty level.
They say the state should go easy on the monthly fines next year.
"We'd like to see those penalties be as least harmful as possible for families who are trying to put this together and trying to comply with the law as best they can," said Lisa Vinikoor, an organizer with the Greater Boston Interfaith Organization. "This is all brand new."
No one knows for sure how many taxpayers will face the loss of their personal exemption or the monthly fees.
Those charged with overseeing the law have celebrated what they said will be the addition of about 300,000 Massachusetts residents to the ranks of the insured this year -- largely as a result of the law.
But no one can say how many uninsured remain.
Earlier this month, Leslie Kirwan, Gov. Deval Patrick's top budget chief and chairwoman of the Connector board, said estimates of the number of uninsured in Massachusetts before the law took effect ranged from 370,000 to more than half a million.
Bliss said officials will have a much better idea as people begin to file their taxes and are forced to say whether they are insured or not.
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On the Net:
The Massachusetts Department of Revenue: http://www.mass.gov/dor
The Massachusetts Commonwealth Health Insurance Connector: http://www.mahealthconnector.org
