Beginning in 2014, the Affordable Care Act (ACA) requires most individuals to obtain acceptable health insurance coverage for themselves and their family members or pay a penalty. This provision is widely known as the “individual mandate.” If you are covered under a health plan offered by your employer, or if you are currently covered by a government program such as Medicare, you can continue to be covered under those programs and will not be impacted by the individual mandate.
How much will the individual mandate penalty cost me?
The penalty for not obtaining acceptable health insurance coverage under the ACA will be phased in over a three-year period. The amount of the penalty is the greater of two amounts—the “flat dollar amount” and “percentage of income amount.”
In 2014, the penalty will start at $95 per person, or up to 1 percent of income. For 2015, the penalty increases to $325 per person or up to 2 percent of income. In 2016 and after, the penalty increases to $695 per person or up to 2.5 percent of income. “Income” for this purpose is your household income minus your exemption (or exemptions for a married couple) and standard deductions. Families will pay half the penalty amount for children. The penalty is charged annually but calculated on a monthly basis - assessed for each month in which you go without coverage. There is no penalty for a single lapse in coverage lasting less than three months in a year.
Because this provision has the effect of “requiring” individuals to have coverage, it is often referred to as the “individual mandate.”