Haris Ashley
As of 2025, Americans will no longer be fined by the federal government for lacking health insurance. However, some states still enforce their own mandates, and penalties vary by income, household size, and filing status. States with penalties for lacking health insurance include California, Massachusetts, New Jersey, Rhode Island, and the District of Columbia. Vermont requires residents to maintain health coverage and report their status, but does not issue fines. The Affordable Care Act (ACA), which included a federal mandate requiring Americans to have health insurance or pay a penalty, was repealed in 2019.
| Characteristics | Values |
|---|---|
| Federal penalty for no insurance | Eliminated at the end of 2018 |
| States with penalties for no insurance | California, Massachusetts, New Jersey, Rhode Island, District of Columbia |
| States without penalties for no insurance | Wisconsin, Oregon |
| States with varying insurance requirements | Vermont, Florida |
| Average penalty amount in 2014 | $200 |
| Number of Americans fined in 2014 | 7.5 million |
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What You'll Learn
The federal penalty for being uninsured was repealed in 2019
The Affordable Care Act (ACA) previously included a federal mandate that required all US citizens to have health insurance or pay a penalty at tax time. However, this federal mandate was officially repealed in 2019, meaning that the federal government will no longer fine citizens for lacking health insurance.
Despite the repeal, some states have introduced their own health coverage requirements with penalties for non-compliance. These states include California, Massachusetts, New Jersey, Rhode Island, and the District of Columbia. The penalties in these states are calculated based on income, household size, and filing status, and the revenue generated is often used to subsidize health programs.
While there is no longer a federal penalty for being uninsured, it is still important to have insurance coverage to protect against large medical bills and ensure access to necessary care. Uninsured individuals can apply for health plans and financial assistance during Open Enrollment each fall.
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Some states still enforce their own mandates and penalties
The federal mandate that required Americans to have health insurance or pay a penalty was repealed in 2019. However, some states still enforce their own mandates and penalties to ensure that more people are insured at lower costs per person. These states include California, New Jersey, Massachusetts, Rhode Island, and the District of Columbia.
California's penalty is based on income and family size, with a minimum fine of around $900 per adult and $450 per dependent child for 2025. The state uses the revenue from this program to offer additional state-funded health insurance subsidies. Rhode Island also has a similar program, with the revenue generated from the penalty used to fund the state's reinsurance program.
Massachusetts' penalty only applies to adults and is based on the person's income and the cost of health plans available via the Massachusetts health insurance exchange. The revenue from the penalty is used to subsidize Health Connector programs.
New Jersey and the District of Columbia also have individual mandates and penalties, with the District of Columbia's penalty based on the federal penalty that existed before the repeal in 2019. These states with individual mandates aim to provide incentives for their residents to obtain health insurance, which can result in lower monthly premiums for taxpayers.
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California's penalty is based on income and family size
In California, the penalty for not having health insurance is based on income and family size. The penalty is either a flat amount based on the number of people in the household or a percentage of gross income above the filing threshold, whichever is higher. For 2023, the flat amount was set at a minimum of $900 per adult and $450 per dependent child under 18. A family of four that goes uninsured for the year would face a penalty of at least $2,700.
The penalty is determined monthly, so a four-month gap in insurance coverage would result in a penalty that is a third of the annual amount. California residents should carry insurance throughout the year, with no gaps in coverage of 90 days or more, otherwise, they may face a tax penalty when they file their tax returns.
There are some exemptions to California's penalty. For example, those with an income lower than the state threshold for tax filing may not need to pay a penalty for not having health insurance. Incarceration, membership of a Native American tribe, and general hardship are also considered grounds for exemption.
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Massachusetts has a penalty for adults without insurance
In 2019, the federal government repealed the Affordable Care Act (ACA), which mandated that all Americans have health insurance or pay a tax penalty. However, some states still enforce their own mandates and penalties for residents without health insurance. Massachusetts is one such state.
Massachusetts requires most adults aged 18 and over with access to affordable health insurance to obtain it. The state's Health Care Reform Act mandates that individuals must be enrolled in health insurance policies that meet minimum creditable coverage standards. These standards are defined by the Commonwealth Health Insurance Connector Authority (the Health Connector).
Individuals who are deemed able to afford health insurance but fail to purchase it are subject to penalties. These penalties are calculated for each month of non-compliance in the tax year and are imposed through the individual's personal income tax return. The penalty amount is based on the person's income and the cost of health plans available through the Massachusetts health insurance exchange. Importantly, there is no penalty if the lapse in coverage is 63 consecutive days or less.
The penalty amount is capped at 50% of the minimum monthly insurance premium for which the individual would have qualified through the Health Connector. Those with incomes less than or equal to 150% of the Federal Poverty Level are exempt from any penalty, as they are not required to pay an enrollee premium for ConnectorCare health insurance. For individuals with incomes above 150% of the Federal Poverty Level, the penalty is typically half of the lowest-priced ConnectorCare enrollee premium or individual Bronze premium, depending on the income level.
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The penalty amount varies by location
The penalty amount for not having health insurance varies across the United States. While the federal penalty was repealed in 2019, some states have continued to enforce their own mandates, with varying financial consequences for uninsured individuals.
California, for instance, enacted legislation in 2019 that imposed an individual mandate with a penalty for non-compliance starting in 2020. The penalty is based on either a flat amount determined by household size or 2.5% of gross income above the filing threshold, whichever is higher. For 2025, the minimum fine is approximately $900 per adult and $450 per dependent child, unless exemptions apply.
Massachusetts also has a penalty for uninsured adults, which is based on their income and the cost of health plans available through the state's health insurance exchange. Similarly, Rhode Island implemented an individual mandate with a penalty for non-compliance, with details of calculations and exemptions available.
On the other hand, some states like Wisconsin and Oregon do not impose a penalty for lacking health insurance. Vermont requires residents to maintain health coverage and report their status, but there is no financial penalty for non-compliance.
The variation in penalties across locations can be attributed to states' efforts to balance the need for insurance coverage with affordable options for their residents. While some states have chosen to impose penalties to encourage coverage, others have sought alternative approaches.
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Frequently asked questions
No, the federal penalty was repealed in 2019. However, some states still enforce their own mandates, and penalties vary by income, household size, and filing status.
As of 2024, there are financial penalties for being uninsured in Massachusetts, New Jersey, California, Rhode Island, and the District of Columbia. Vermont requires residents to maintain health coverage but does not fine those without insurance.
The penalty amount varies by state. In California, the minimum fine for 2025 is around $900 per adult and $450 per dependent child, unless an exemption is qualified. In Massachusetts, the penalty amount is based on the person's income and the cost of health plans available via the state's health insurance exchange.
During the annual Open Enrollment Period (OEP), all eligible Americans can shop for an Affordable Care Act-compliant health plan. You may qualify for subsidies or exemptions based on your income and family size.
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