Will I Get a Fine or Penalty for Not Having Health Insurance?

The U.S. federal government requires you to have minimum health coverage but will no longer impose a penalty for not having health insurance. However, a fine at the state level may still apply if you without health insurance and live in California, Massachusetts, New Jersey, Rhode Island or Washington D.C.

Keep reading to learn what fines you may face if you live in a state that mandates having health insurance coverage.

Key Takeaways Today, U.S. citizens no longer risk paying a federal tax penalty if they do not have health insurance. Penalties for forgoing health insurance coverage may still exist at the state level, specifically in California, Massachusetts, New Jersey, Rhode Island and Washington D.C. Fines can range from a few hundred dollars to thousands of dollars depending on your state, household income and size and is typically due when you file your taxes. To avoid paying a penalty in your state, be sure to buy a health insurance plan during open enrollment.

Is Health Insurance Required?

Enacted in 2017, the Tax Cuts and Jobs Act eliminated the federal penalty for not having health insurance. You are still required to have minimum essential coverage — you just won’t have to pay a federal tax fine if you go without it for the tax year. However, a handful of states still require their residents to maintain coverage or risk paying a fine if they forgo coverage.^[1]

Which States Have a Tax Penalty for Not Having Health Insurance?

You must have health insurance or risk paying a tax penalty if you live in California, Massachusetts, New Jersey, Rhode Island or Washington, D.C. The states of Maryland and Vermont do require their citizens to state whether or not they have health coverage on their tax forms, but there is no health insurance tax penalty for not having any.^[2][3][4]

How Much Is the Tax Penalty if You Don’t Have Health Insurance?

Depending on where you live, the tax penalty for not having health insurance can range from a few hundred dollars to $19,000 and up.

State/District	Tax Penalty for Not Having Health Insurance
California[5]	At least $900 per adult and $450 per dependent child
Massachusetts[6]	$288 to $2,196 depending on household size and income
New Jersey[7]	$695 to $19,800 depending on household size and income
Rhode Island[8]	Varies based on income, number of household members and the cost of a bronze plan
Washington, D.C.[9]	2.5% of household income OR $695 per adult and $347.50 per child, whichever is higher

California

Californians who go without coverage for the full year will incur a minimum tax penalty of at least $900 per adult and $450 per dependent child.^[5] A family of two adults and two dependent children without insurance could be penalized at least $2,700.

Massachusetts

In Massachusetts, individuals earning below 150% of the federal poverty level (FPL) face no penalty for lacking health insurance, while those with incomes between 150.1% and 300% FPL pay penalties ranging from $24 to $68 monthly based on their income level.^[6] For incomes above 300% FPL, the penalty is $183 monthly.

Married couples without insurance pay combined penalties corresponding to their individual income levels. Annual FPL income standards will change based on your family size and income and can range from $20,385 for an individual to $139,890 for a family of eight.^[6]

New Jersey

For the 2024 tax year in New Jersey, individuals without health insurance will have to pay a penalty not exceeding the average cost of a bronze plan and will be based on their household size and income. For example, an individual taxpayer may pay a fine of $695, while a family with two adults and three dependents may face a fine as high as $19,800.^[7]

Filing Status	Penalty
Individual taxpayer	Minimum: $695 Maximum: $3,960
Family with two adults and three dependents and household income of $200,000 or below	Minimum: $2,351 Maximum: $4,500
Family with two adults and three dependents and household income of $200,001 to $400,000	Minimum: $2,351 Maximum: $9,500
Family with two adults and three dependents and household income of $400,001 and above	Minimum: $2,351 Maximum: $19,800

Rhode Island

In Rhode Island, the health insurance mandate penalty is calculated by comparing three methods.^[8] The first method applies a monthly rate to the number of uninsured adults and children. The second method takes into account 2.5% of your income after deductions, as well as the number of household members. The third method is based on the cost of a bronze health insurance plan, multiplied by the number of months you went uninsured. The final penalty on your tax return is the lowest amount resulting from these three methods.

District of Columbia

Under the individual mandate, U.S. citizens in Washington D.C. must have health insurance or pay a fine of either 2.5% of the household’s income or $695 per adult and $347.50 per child, whichever is higher.^[9]

As a side note, businesses with over 50 full-time employees must insure at least 95% of their workforce or incur penalties — $2,000 per uninsured full-time employee and $3,000 for each full-time employee receiving insurance subsidies through the healthcare exchange.

When Do You Have To Pay the Penalty for Not Having Health Insurance?

If you face a penalty for not having health insurance, you will typically pay the fine when you file your taxes. Tax return deadlines are on April 18 in Massachusetts, New Jersey, Rhode Island and Washington, D.C.^{[10][11][12][13]} Meanwhile, the filing deadline in California is November 16.^[14]

What Are the Exemptions?

If you face financial hardship, you may be exempt from paying the health insurance fine.

The hardship exemptions fall under two types: affordability exemptions and hardship exceptions.

For an affordability exemption, if a healthcare plan costs you over 8.09% of your household income, you won’t have to purchase coverage.^[15] The criteria for qualifying for a hardship exemption would vary by state but might include the following scenarios:^[16]

• You experienced homelessness, eviction, foreclosure, or received a utility shut-off notice.
• You were a victim of domestic violence or suffered the death of a family member.
• You faced significant property damage due to disasters like fires or floods.
• You declared bankruptcy or had overwhelming medical expenses leading to substantial debt.
• You shouldered unexpected expenses while caring for a sick or elderly relative.
• You have a tax-dependent child denied Medicaid or CHIP coverage, despite a court order for someone else to provide medical support.
• Following an eligibility appeals decision, you gained access to Marketplace insurance, premium subsidies, or cost-sharing reductions retroactively.
• Your state's refusal to expand Medicaid under the Affordable Care Act (ACA) left you ineligible for coverage.
• You encountered other difficulties that prevented you from obtaining health insurance.

How Long Do I Have To Shop for Health Insurance Before I’m Penalized?

You will have the run of open enrollment to purchase health insurance coverage before you receive a penalty charge. The start and end dates for open enrollment can vary by state.

Open enrollment for California, New Jersey and Rhode Island run from November 1 to January 31.^[16][17][18] Massachusetts' health insurance exchange is open from November 1 to January 23 and the District of Columbia's goes from November 14 to December 12.^[19][20]

If you end up purchasing a plan, open enrollment would also be the time when you would switch plans to something that better fits your needs.

In addition, it’s worth noting that for those who miss open enrollment, it may still be possible to get coverage during a special enrollment period. In order to qualify for special enrollment, you would need to have a qualifying life event that prohibited you from procuring coverage during your area's standard enrollment period.

How To Get Health Insurance and Avoid Tax Penalties

Securing the right coverage usually involves comparing quotes from at least three to five different insurance providers. They'll want to know specifics like the number of dependents in your household, your finances and whether anyone in your household smokes. Compiling and repeating this information for each provider can be monotonous.

That's where an insurance hub like SmartFinancial comes to the rescue. With a one-time, straightforward questionnaire tailored to your insurance requirements and financial limits, you can connect with a health insurance policy that fits your life needs, sometimes within moments. To kickstart the matching process and obtain your no-cost insurance quote, simply drop in your zip code below.