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What happens if I don’t buy health insurance after 2014?

  • By
  • healthinsurance.org contributor
  • October 3, 2013

Q. What happens if I don’t buy health insurance after 2014?

A. The health reform law includes an individual mandate, requiring every American to have health coverage, with just a few exceptions. It includes a penalty for anyone who does not buy health insurance.

ACA open enrollment guide

The Insider’s Guide to Obamacare’s Open Enrollment offers time-saving strategies for selecting coverage during open enrollment. (Click the image for a free download.)

The penalties are phased in:

In 2014, the penalty is $95 per uninsured adult (the penalty for uninsured children is always half the adult amount, but in 2014 there’s a $285 cap for a family) OR 1 percent of taxable household income, whichever is greater.

In 2015, the penalty is $325 per uninsured adult (family cap of $975) OR 2 percent of taxable household income, whichever is greater.

And in 2016, the penalty increases to $695 per uninsured adult (family cap of $2,085) OR 2.5 percent of household income, whichever is greater.

There are some exceptions to the penalty though. You don’t have to pay if:

  • you can’t find a premium for a qualified plan through your state health insurance exchange that is less than 8 percent of your adjusted gross income;
  • your income is below the tax filing threshold;
  • you have a hardship waiver;
  • you are not covered for a period of less than three months during the year;
  • you have a religious objection;
  • you’re a member of a healthcare sharing ministry;
  • you’re a member of an Indian Tribe;
  • you’re incarcerated; or
  • you’re not legally present in the U.S.

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