Is there still a penalty for being uninsured?

DC, Massachusetts, New Jersey, California, and Rhode Island have penalties for being uninsured

Although the IRS is not penalizing people who are uninsured in 2019 and beyond, states still have the option to do so. A handful of states have their own individual mandates and penalties for non-compliance:

Massachusetts implemented an individual mandate and penalty in 2006, and it continues to be in effect²

• People who were uninsured in Massachusetts between 2014 and 2018 didn't have to pay both the state and federal penalties, but now that there's no federal penalty, the state's penalty applies just as it did before 2014.
• The Massachusetts penalty only applies to adults, and the penalty amount is based on the person's income and the cost of health plans available via the Massachusetts health insurance exchange.
• Here are the Massachusetts penalty amounts for the 2025 tax year, and here's where you can see information about available exemptions.
• Revenue from the Massachusetts individual mandate penalty is used to subsidize Health Connector programs.³

The District of Columbia implemented an individual mandate and penalty that took effect in January 2019.⁴

• The penalty amounts are based on the amounts that applied under the federal penalty in 2018 (a flat $695 per adult — half that for a child — or 2.5 % of income, whichever is higher), although the maximum penalty under the percentage of income calculation is based on the average cost of a bronze plan in DC, as opposed to the average nationwide cost of a bronze plan.⁵
• DC has a tool you can use to see if you qualify for an exemption
• Revenue from DC's individual mandate penalty is deposited into the District's Individual Insurance Market Affordability and Stability Fund, which is used to fund outreach and education about available health coverage, or to increase the availability of coverage options or the affordability of individual market premiums.⁶

New Jersey also implemented an individual mandate and penalty that took effect in January 2019.⁷

• The penalty amounts also mirror the previous federal penalty, but the maximum penalty under the percentage of income calculation is based on the average cost of a bronze plan in New Jersey.
• Here are New Jersey's calculators for determining the penalty amount for each year.
• Here's where you can determine whether you might be eligible for an exemption from the penalty in New Jersey.
• New Jersey uses penalty revenue to help fund its reinsurance program.

California enacted legislation in 2019 that created an individual mandate starting in 2020, with a penalty for non-compliance.⁸

• The penalty is the higher of either a flat amount (based on the number of people in the household) or 2.5% of gross income above the filing threshold requirements.⁸
• California has an information page where you can learn more about penalty amounts and available exemptions.
• California is using revenue from this program to offer additional state-funded health insurance subsidies.

Rhode Island also implemented an individual mandate effective in 2020, with a penalty for non-compliance.⁹

• Details of how the penalty is calculated, exemptions, and applicable tax forms can be seen here.
• The revenue generated from the penalty is used to help fund the state's reinsurance program. Both the individual mandate and the reinsurance program were designed to have a stabilizing effect on Rhode Island's individual/family market.

Easy enrollment programs also use state tax forms

Several states — including three of the states that have individual mandate penalties — have created "easy enrollment" programs. These programs also utilize the state tax return to determine whether a filer had health coverage in the prior year. But rather than being used to impose a penalty, the information provided on the tax return is used to connect uninsured residents with available health coverage.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.