If the Washington ruling stands, more than five million people who have signed up for health insurance under the PPACA may not be able to afford the coverage without the tax credits. This ruling also may have an effect on the individual mandate portion of the PPACA. Under the PPACA, individuals are required to purchase insurance or pay a fine. However, individuals can apply for a hardship exemption if health insurance premiums would exceed 8 percent of their household income, a scenario that is more likely if individuals do not have access to subsidies.