No Health Care? Expect A Requirement To Get It

House and Senate committees are in the midst of haggling over such issues, and independent analysts expect a final bill to emerge that includes both waivers and sliding-scale subsidies to meet Obama's conditions

"There's no doubt that to be acceptable, it has to be regarded as fair and that you're not requiring people to buy insurance that's not affordable to them," said John Holahan, the Urban Institute's health policy center director.

Any plan is likely to be modeled after one in Massachusetts, which required that virtually everyone have health insurance or face tax penalties.

People who were deemed able to afford health insurance but who refused to buy it during 2007 faced losing a personal tax exemption and the prospect of monthly fines. The law exempted anyone who made less than the federal poverty level and gave them free care. And, those making up to three times the poverty level could get subsidize plans. Businesses with 11 or more full-time employees who refused to offer insurance also faced fines.