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Home » Obamacare (Health Insurance) » Six States Require Health Insur­ance For 2020

Six States Require Health Insur­ance For 2020

October 15, 2019 by Shae Irving

Hand stacking blocks to illustrate state individual mandates for health insurance

The fed­eral tax penalty for going with­out health insur­ance ended in 2019, but a hand­ful of states have enacted their own laws to replace it. The legal term for this type of health insur­ance require­ment is an “indi­vid­ual mandate.”

For 2020, state indi­vid­ual man­dates exist in Cal­i­for­nia, the Dis­trict of Colum­bia, Mass­a­chu­setts, New Jer­sey, Rhode Island, and Ver­mont. For the most part, these state laws mir­ror the for­mer require­ments of the Afford­able Care Act. In all but one (Ver­mont), you may face a state tax penalty if you are unin­sured in 2020.

States With Indi­vid­ual Man­dates for Health Insurance

Here’s a sum­mary of each state’s indi­vid­ual man­date rules.

Cal­i­for­nia

Begin­ning Jan­u­ary 1, 2020, Cal­i­for­nia law requires you to have health insur­ance. A com­pli­cated for­mula deter­mines the penalty you may face, but it’s sim­i­lar to the for­mer ACA penalty. That means $695 per unin­sured adult ($347.50 per child) up to a max­i­mum of $2085 or 2.5% of your house­hold income, whichever is greater. For the income-​based cal­cu­la­tion, the max­i­mum penalty is the aver­age annual cost for a bronze plan from Cov­ered Cal­i­for­nia. To learn more, see our sum­mary of cov­er­age require­ments and exemp­tion rules for Cal­i­for­nia.

Dis­trict of Columbia

The D.C. health insur­ance man­date took effect on Jan­u­ary 1, 2019. Like most of the other state indi­vid­ual man­dates, the penalty is $695 for each unin­sured adult (half that amount for a child) up to a max­i­mum of $2085 or 2.5% of house­hold income, whichever is greater. For the income per­cent­age cal­cu­la­tion, the max­i­mum penalty is the aver­age annual cost of a bronze plan pur­chased at D.C. Health Link. To find out what counts as cov­er­age and whether you’re exempt, see Do I Have to Get Health Insur­ance in the Dis­trict of Colum­bia?

Mass­a­chu­setts

The Mass­a­chu­setts health insur­ance require­ment does not track the Afford­able Care Act’s struc­ture. That’s because the state had an indi­vid­ual man­date for sev­eral years before the ACA passed. In fact, the Mass­a­chu­setts man­date inspired the ACA’s health insur­ance require­ment. In Mass­a­chu­setts, the penalty may be as much as 50% of what you would have paid to get cov­ered by a plan sold at Mass­a­chu­setts Health Con­nec­tor. For a sum­mary of min­i­mum cov­er­age require­ments and exemp­tion rules, see Do I Have to Get Health Insur­ance in Mass­a­chu­setts?

New Jer­sey

The New Jer­sey indi­vid­ual man­date took effect on Jan­u­ary 1, 2019, and it’s based on the for­mer ACA penalty. Those who are unin­sured for all of 2020 will have to pay $695 per adult/$347.50 per child (up to a house­hold max­i­mum of $2,085) or 2.5% of house­hold income, whichever is greater. The max­i­mum penalty for the income-​based cal­cu­la­tion is the aver­age yearly pre­mium of a bronze plans in New Jer­sey. To learn what qual­i­fies as min­i­mum cov­er­age and whether you may be exempt, see Do I Have to Get Health Insur­ance in New Jer­sey?

Rhode Island

Begin­ning Jan­u­ary 1, 2020, Rhode Island law requires you to have health insur­ance unless you qual­ify for an exemp­tion. It too bases its penalty on the ACA struc­ture: $695 per unin­sured adult ($347.50 per child) up to a max­i­mum of $2085 or 2.5% of your house­hold income, whichever is greater. For the income per­cent­age cal­cu­la­tion, the penalty is capped at the aver­age annual pre­mium cost for a bronze-​level plan pur­chased at Health Source RI. Here’s a sum­mary of cov­er­age require­ments. The state has­n’t yet pub­lished exemp­tion guidelines.

Ver­mont

Ver­mont law requires you to have health insur­ance begin­ning Jan­u­ary 1, 2020. But state law­mak­ers haven’t been able to agree on what the penalty should be. For now, it looks like you’ll have to report whether you have 2020 health cov­er­age when you file your Ver­mont tax return, but you won’t have to pay any­thing for being uninsured.

For More Information

Open enroll­ment for 2020 health plans is com­ing soon. In most states, it starts Novem­ber 1 and runs through Decem­ber 15. (In Cal­i­for­nia, open enroll­ment starts today, Octo­ber 15!) For infor­ma­tion about find­ing afford­able health insur­ance where you live, visit Legal Consumer’s Oba­macare learn­ing cen­ter.

Filed Under: Obamacare (Health Insurance) Tagged With: aca, affordable care act, california, district of columbia, individual mandate, massachusetts, new jersey, rhode island, vermont

About Shae Irving

Shae Irving has been writing for Legal Consumer since 2013, focusing on health care and family law. She was a senior legal editor and editorial project manager at Nolo, where she worked for twenty-two years. Shae has degrees in rhetoric and law from U.C. Berkeley. She lives in Northern California.

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