The fine for not having insurance was repealed for 2019 but is still in place for 2018.
The "fine" AKA the Shared Responsibility Payment
If you can afford health insurance but choose not to buy it, you must pay a fee called the individual shared responsibility payment. (The fee is sometimes called the "penalty," "fine," or "individual mandate.") The shared responsibility payment keeps costs down for insurance companies because it ensures healthy people will be included in insurance pools or pay into it even if they don't have insurance. This allows for the patient protections of the ACA, like the pre-existing rule and caps on coverage.
Who will be fined for not having health insurance?
If you or your dependents have a gap in qualifying insurance coverage of three months or more, you may be required to pay the fine. This information is reported on your income tax return and is obtained from the information you provide and that provided on 1095 forms. You may be exempt from this payment if, for example:
- Affordable coverage options are not offered by your employer (more than 8% of your annual income)
- The gap in insurance coverage is three or fewer consecutive months
- You belong to a group that is explicitly exempt from participating in the Affordable Care Act by the Internal Revenue Service (IRS)
Who will NOT be fined?
People in the following situations can get an exemption from the law:
- People who qualify for religious exemptions
- Undocumented immigrants
- People who are incarcerated
- Members of federally-recognized tribes and certain other Native Americans
Other exemptions could include:
Affordability exemption: The cost of insurance was deemed “unaffordable.” If the lowest cost Bronze-level Marketplace plan available to you in 2018 cost more than 8.05 percent of your household income.
Hardship exemption: Anyone who has had one of the following life events that kept them from having insurance:
- Being homeless
- Eviction in the past 6 months or were facing eviction or foreclosure
- Experiencing a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property
- Filing for bankruptcy in the last 6 months
- Having medical expenses you couldn’t pay in the last 24 months
If you think you qualify for an exemption, visit the FORMS YOU MAY NEED tab to see if you're eligible.
How much is the fine?
The fee is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher:
Percentage of income
- 2.5% of household income
- Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace
- $695 per adult
- $347.50 per child under 18
- Maximum: $2,085