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Individual Responsibility Requirement (Individual Mandate)

The individual responsibility requirement, also known as the individual mandate, is a provision of the Affordable Care Act requiring that all citizens obtain a minimum standard of health insurance coverage starting in 2014, obtain an exemption, or pay an extra fee (a tax) when filing their federal income tax return through the 2018 plan year. After 2018, there is still a requirement to maintain coverage, although you will not be charged a tax penalty unless you live in Massachusetts, New Jersey, or the District of Columbia. Still, maintaining “Minimum Essential Coverage” is required by federal law, and obtaining such coverage determines your eligibility for premium tax credits and most special enrollment periods. Also, health insurance coverage provides important financial protection in case you need health services such as when you are sick or have an injury.

People can obtain the necessary coverage through their job, through a government program such as Medicaid or Medicare, or through the health insurance marketplace in their state.

Exemptions from the individual mandate are also available to those that qualify. Most exemptions can be obtained through the tax filing process, but certain exemptions must be applied for and granted through the health insurance marketplace.