QUESTION

I heard they repealed the individual mandate. Do I still need to have coverage this year?

Individuals with no coverage | Individual Responsibility Requirement (Individual Mandate)
ANSWER

Yes, you still need to have coverage this year to avoid paying a penalty. The ACA’s individual mandate was not repealed. The Tax Cuts and Jobs Act that was signed into law in December 2017 reduced the tax penalty for not complying with the ACA’s individual responsibility requirement to $0 beginning in 2019. That means that federal law still requires you to have minimum essential coverage for 2018, or risk paying the penalty if you do not qualify for an exemption from the coverage requirement.

The penalty does not zero out until plan year 2019, for which most people will file taxes in 2020. When you file taxes in 2018 for 2017 and in 2019 for 2018, if you did not have minimum essential coverage for the entire year, you may be liable for a tax penalty, equal to the greater of:

  •  $695 for each adult and $347.50 for each child, up to $2,085 per family, or
  •  2.5% of family income above the tax filing threshold, capped at the national average of the lowest cost bronze plan available through the marketplace.

Some types of coverage sold outside the health insurance marketplaces do not qualify as minimum essential coverage, such as medical discount cards, short-term and fixed indemnity policies. These kinds of products are sometimes referred to as “excepted benefits,” and do not fulfill the ACA’s individual responsibility requirement, potentially exposing you to the tax penalty while it is still in effect. To find out if your plan counts as minimum essential coverage, look over you Summary of Benefits and Coverage, or contact your insurer. (26 U.S.C. § 5000A (b)–(c); IRS, Rev. Proc. 2017-58; Tax Cuts and Jobs Act of 2017, Pub. L. No.115-97, § 11081 (2017))

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues