Under the ACA, starting January 1, 2014, all individuals and their dependents, unless exempt, must have and maintain minimum essential health coverage. Minimum essential coverage can be provided through an individual plan (in or outside an exchange), an employer plan (in or outside an exchange), or a government plan, such as Medicare or Medicaid. If a person does not have or does not maintain minimum essential coverage, he or she is subject to a tax penalty. (The federal government refers to the tax penalty as a “shared responsibility payment.”)
The penalty applies to each uninsured in a household and is the greater of a specified dollar amount or a percentage of household income:
||% of Income Penalty
||$95 for each uninsured adult in the household (capped at $285 per household)
||1% of household income
||$325 for each uninsured adult in the household (capped at $975 per household)
||2% of household income
||$695 for each uninsured adult in the household (capped at $2,085 per household)
||2.5% of household income
|* For household members younger than 18, the dollar penalty is half the amount. Any penalty owed is prorated for the number of months of no coverage.
Exceptions to the individual mandate may be given for religious objections or financial hardship, to members of nationally recognized Indian tribes, and to those who have been insured for fewer than three months.