Individual Mandate

Summary

The individual mandate requires individuals who are not exempt to either maintain minimum essential coverage for themselves and any nonexempt family members or include an individual shared responsibility payment with their federal income tax return.

The health insurance required must be minimum essential coverage (MEC) or an individual would pay a potential penalty for noncompliance. For this individual mandate, coverage may be obtained through government programs such as Medicare or Medicaid; employer plan; health plan purchased through the Health Insurance Marketplaces; health plan purchased outside of the Marketplaces.

Recent guidance removes the penalty associated with the individual mandate beginning in 2018.  The final penalty will occur for individuals not complying with the mandate when they file their income tax return in 2019.

Cost of Individual Mandate Penalty

If individuals do not elect coverage offered by their employer, do not have other coverage and do not meet one of the narrow exemptions, there will be a tax penalty based on an individual's income. Please consult a tax advisor with questions or visit healthcare.gov.

  • 2015 – $325 per uninsured person or 2 percent of household income over the filing threshold (whichever is greater)
  • 2016 to 2018 – $695 per uninsured person or 2.5 percent of household income over the filing threshold (whichever is greater); children under 18 are $347.50
  • 2019 – NO FURTHER PENALTY