There is no longer a penalty UNLESS you live in a state that requires it.
Previous penalty for not having health insurance in 2022
The fee was calculated 2 different ways – as a percentage of your household income, and per person. You 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
However, the fee is prorated and the average penalty is around $200.
Additionally, there is no penalty if you have had ACA compliant coverage for 10 months. This means you can purchase a less expensive short term plan to cover you for November and December with no penalty.
The fee for not having health insurance in 2023
There is no penalty for not having ACA mandated coverage in 2023 unless you live in a state like New Jersey or Massachusetts where it is mandated by the state. Because of this, short-term medical plans will be extremely popular in 2023 because they provide access to larger PPO networks at lower prices than ACA Bronze plans.
State-level health insurance penalties still may be in effect.
While there will not be penalties at the federal level anymore for going uninsured or choosing a plan that is not ACA-compliant, it is still important to look at state requirements for health insurance. A large handful of states have their own health insurance penalties that are assessed when people do not have insurance that complies with that state’s laws.
Some places where a health insurance penalty is still assessed:
- New Jersey. This state has a health insurance penalty that went into effect in 2019. The health insurance penalty is based on New Jersey’s prices for bronze level health insurance policies.
- Massachusetts has had a health insurance penalty since instituting a state health insurance program in 2006. In the past, they did not assess a health insurance penalty if someone paid one at the federal level. However, with the elimination of the federal health insurance penalty, they will begin charging a state fee.
- Vermont has instituted a health insurance penalty for uninsured individuals in that state. The health insurance penalty law went into effect in 2020.
- District of Columbia. This city has signed their own health insurance penalty into law. It went into effect in 2019.