Your Source for Health Reform

Topic: Individual Mandate



The ACA requires that everyone have health coverage in some form. Those who not have insurance, and do not fall into one of the exemption categories, are subject to a penalty. The penalty fee is $95 or prorated 1% of income for 2014, and increases in later years. The constitutionality of this part of the law was challenged, and was upheld by the U.S. Supreme Court.


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Exceptions to the Individual Mandate

This grid from Families USA lists out  exemptions to the requirement of having health insurance and how people can apply for them. The grid was updated in October 2015 and applies to the 2016 tax-filing season.

Getting Ready for Tax Day

This January 2016 blog post from the HealthCare.gov CEO lays out what consumers should expect in the second tax-filing season under the ACA. The post details processes for consumers with Marketplace insurance; consumers with Medicaid, Medicare or employer-sponsored insurance; and for those without coverage.

It’s Almost Tax Time!

This January 2016 news article from CBS News describes the three tax forms, the 1095-A, 1095-B and 1095-C that will be used by the IRS to collect information on health insurance coverage.

The New Shared Responsibility Provision 

This October 2015 flow chart from the Kaiser Family Foundation identifies whether an employer will be subject to penalties for not offering health coverage for their employees in 2016.

Roundup of OE2 Q’s

The Georgetown University Centers For Children and Families and Health Insurance Reforms compiled a list of common questions raised during the second open enrollment period. The February 2015 FAQ covers tax-filing issues, counting household income and employer coverage.

Different Tax Docs

State refor(u)m updated this chart in February 2015 to outline the new forms tax-filers must fill out because of the ACA. The chart identifies the purpose of the forms and who are required to complete them.

Calculate Your ACA Tax Penalty

The Tax Policy Center created a tool that estimates a person’s fine for not having health insurance during 2014.

Getting a Health Insurance Exemption

This March 2014 Issue brief from the Centers for Medicare and Medicaid Services identifies populations who may be exempt from purchasing health insurance. The brief lays out the exemption process- including documentation needed- for each group.

Linking Justice-Involved Youth with Healthcare

This January 2014 resource guide from Illinois state government describes strategies for connecting young adults in the criminal justice system with health insurance coverage.

Tax-Filing Recs Post ACA

This December 2014 tip sheet from the Centers for Medicare and Medicaid Services educates marketplace plan consumers on what changes they should expect during tax-filing season. CMS advises people who had coverage through the marketplace, those who received tax credits, and people without health insurance.

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