Medicare Faqs

What Are the Penalties If People Do Not Buy Health Insurance as Required by the Affordable Care Act (ACA)?
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Starting in 2014, the Affordable Care Act (ACA) requires that most people have health insurance or pay a penalty if they do not. Coverage may include employer-provided insurance or insurance purchased on the individual market.

The penalty -- which amounts to a tax based on the Supreme Court ruling upholding the law -- for people who forgo insurance is the larger of two amounts: a dollar amount or a percentage of income. For example, in 2014, if people do not buy insurance as an adult, they will pay either $95, or 1 percent of their family income, whichever is greater. For a child, the penalty is $47.50. The maximum penalty for a family would be either $285, or 1 percent of income.

The penalty increases with time. In 2015, it would be $325 for an adult and $162.50 for a child (with a family maximum of $975), or 2 percent of family income, whichever is greater. In 2016 and later, it would be $695 for an adult and $347.50 for a child (with a family maximum of $2,085), or 2.5 percent of family income, whichever is greater.

The Congressional Budget Office projects that 3.9 million people will pay a penalty in 2016. The total penalty someone can pay will be limited to the average of the cost of a basic insurance policy sold through the public exchanges, starting in 2014.

It would be up to the IRS to verify that individuals comply with the health insurance mandate, and to collect any tax penalty from them if they aren’t.


RELATED FAQS

Will Everyone Be Forced to Buy Health Insurance Under the Affordable Care Act (ACA)? 

What Is the Individual Mandate as Required by the Affordable Care Act (ACA)? 

How Does the Health Insurance Mandate Apply to Employers? 

What Were the Potential Outcomes of the Supreme Court Examination of the Affordable Care Act? 


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