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Health Care Reform:

Health Insurance & Affordable Care Act

Who Won't Have to Pay for Insurance or a Penalty?

If you answer yes to any of these questions, you are exempt. That means you don't have to buy health insurance. And you won't have to pay a penalty either. 

Do you make so little money that you don't have to file taxes?

For 2013, if you earn less than $10,000 you don't have to file a tax return. For a family you don't have to file a tax return if you made less than $20,000. 

Do you get help paying for your health care from one of these?

  • Medicare, the government health insurance program for people age 65 or older
  • Medicaid or CHIP, health insurance programs for lower-income adults and children
  • A veteran's health plan
  • TRICARE, an insurance program for members of the military, retirees, and their families

Are you in any one of these groups?

If you fit into one of the groups below, you don't have to pay a fine for not having insurance:

  • American Indian
  • Undocumented immigrant
  • Prisoner
  • Your religion doesn't believe in health insurance
  • An American who is living abroad for more than one year

Will you have to pay more than 8% of your income for health insurance?

Single adults whose employer does not offer insurance and who cannot find a health plan on their state's Marketplace with a monthly premium amount that is less than 8% of their total monthly earnings are exempt. That means they do not have to buy insurance or pay a penalty. This does not apply to family incomes.

To figure out if this is true for you, look at your pay stub for the last month -- a few months if the amount you get varies. Multiply that total by 0.08. That is 8% of your monthly income.

If you get insurance from your employer: Look at all the health plans your company offers. Find the one with the lowest monthly payment, which is called the premium.

  • Subtract any contributions you can get from your employer from that lowest premium amount.
  • If the amount is more than what you calculated as 8% of your monthly income, you are exempt.
  • If the amount is less than what you calculated, by law, you need to get insurance. If you don't get it, you'll have to pay a penalty.

If your employer doesn't offer insurance: Starting in October 2013, you can go to your state's health insurance Marketplace to find out how much financial help you can get.

  • Go through the process to find insurance for you. You'll select your family size. And you may enter how much money you make a year or answer questions about how much you make.
  • Pick a low-cost plan to see how much the yearly premium is. Look to see if they offer any bronze-level plans, because those have the lowest monthly payments. If you are younger than 30, you can look at a catastrophic plan, which tends to have the lowest monthly premium.
  • Use your state's calculator to see how much the premium is after any available subsidies from the government.
  • If the monthly premium amount is more than what you calculated as 8% of your monthly income, you are exempt.
  • If the premium amount is less than what you calculated, you need to get insurance. If you don't get it, you'll have to pay a penalty.

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