Your Source for Health Reform

Topic: Penalty



The ACA stipulates that people who do not have coverage must pay a penalty, which is done via their tax return the following year. The penalty started at $95 or 1% of income, whichever is greater, for 2014 and increases every year. There is also a penalty for employers with 50 or more FTE employees who fail to offer affordable coverage to their workers.


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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.

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.

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.

Paying Taxes Without Insurance

A January 2015 issue brief from the Centers for Medicare and Medicaid Services outlines what uninsured tax payers should expect during the upcoming tax season. The brief identifies exempt populations and where to get tax help.

The ACA’s Changes to Tax Returns

This December 2014 question and answer from the IRS outlines changes to tax filing because of the healthcare reform law. The IRS details how individuals report minimum essential coverage on their tax forms and how to reconcile or claim premium tax credits.

When the Individual Mandate Doesn’t Apply

This September 2014 fact sheet from the IRS highlights cases that would exempt individuals from purchasing health insurance. The sheet identifies whether individuals should seek an exemption from the IRS or the marketplace.

Not Invincible – But Perhaps Convincible

These findings from Deloitte’s April 2014 survey contradict the stereotype young adults (age 19-34) as healthy, risk-taking young “invincibles.” Among those who didn’t sign up for coverage, few said it was because they don’t expect to need insurance. Those who did get insurance said the most important reasons were to pay medical bills, to secure peace of mind, and to avoid paying the federal penalty.

Types of Exemptions from the Requirement to Have Health Insurance

This 2013 chart from Families USA provides an overview of the different reasons you could get an exemption, where and when you need to apply, and how long each type of exemption lasts.

Understanding the Requirement to Have Health Insurance

This 2013 fact sheet from Families USA answers common questions about the ACA’s requirement that everyone must have health insurance that covers their basic health needs.

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