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Which group is NOT exempt from the Affordable Care Act's requirement to purchase coverage?

  1. Members of a religion opposed to acceptance of health care benefits

  2. Undocumented immigrants

  3. Those who must pay less than 9.5% of their income for health insurance

  4. Those whose household income does not require filing a tax return

The correct answer is: Those who must pay less than 9.5% of their income for health insurance

The correct option highlights individuals who must pay less than 9.5% of their income for health insurance as not being exempt from the Affordable Care Act's requirement to purchase coverage. Under the ACA, if a person's insurance premium exceeds a certain percentage of their income, they may qualify for an exemption. Specifically, the affordability threshold is set at 9.5%, meaning that if individuals can afford coverage at that rate or less, they are expected to enroll in a health insurance plan rather than seek an exemption. This provision is designed to ensure that insurance is affordable for Americans in varying income brackets, creating a balance in the healthcare system by requiring those who can afford coverage to acquire it. The obligation to obtain insurance under the ACA also promotes wider participation in the health insurance pool, which is essential for spreading risk and managing costs. The other groups mentioned may qualify for exemptions for specific reasons; for example, members of certain religious groups may be opposed to insurance altogether, undocumented immigrants do not qualify for many government programs including ACA benefits, and those with extremely low incomes are not mandated to file tax returns or purchase health insurance. However, individuals who can afford coverage but fall under the affordability threshold have a requirement to obtain it.