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Many Individuals Are Required To Be Insured

The Affordable Care Act requires many U.S. citizens and legal residents to be insured or pay a penalty. This is also known as the “individual mandate.”

The penalty took effect in 2014. The annual fees are broken down as follows:

  • 2014: Penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1.0% of family income, whichever is greater.
  • 2015: Penalty is $325 per adult and $162.50 per child (up to $975 for a family) or 2.0% of family income, whichever is greater.
  • 2016 and beyond: Penalty is $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of family income, whichever is greater.

Penalties for the individual mandate are collected by the IRS through the income tax process.

Exemptions will be made for a variety of reasons, such as financial hardship or religious objections.

The Kaiser Family Foundation individual mandate flowchart can help you decide whether or not the mandate applies to you.

Lower Your Monthly Health Plan Premiums
If you enroll through the NY State of Health Marketplace, you may be eligible for an Advanced Premium Tax Credit, also known as an individual subsidy, or the Cost-Sharing subsidy, which limits maximum out-of-pocket costs. Both can be used to lower what you pay for your monthly health plan premiums.