How does the Affordable Care Act (ACA) affect me as an individual?

Beginning in 2019, the Tax Cuts and Jobs Act has eliminated the penalty imposed on individuals who are not covered by a health care plan that provides at least minimum essential coverage, as outlined in the Affordable Care Act.

Be aware of state mandates, however. Some states are enacting their own state-wide health care individual mandates.

  • California (effective in 2020)
  • Rhode Island (effective in 2020)
  • The District of Columbia
  • Massachusetts
  • New Jersey
  • Vermont (Vermont’s mandate takes effect in 2020, but it does not include a penalty for non-compliance, so it’s essentially the same as the current federal mandate)

How do I get the Premium Tax Credit?

The premium tax credit is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace. You are eligible for the premium tax credit if you meet all of the following requirements:

  • Have household income that falls within a certain range.
    • Individuals up to $51,040
    • Family of two up to $68,960
    • Family of four up to $104,800
  • Do not file a tax return using the filing status of Married Filing Separately.
  • Cannot be claimed as a dependent by another person.
  • Meet these additional requirements: In the same month, you or a family member:
    • Have health insurance coverage through a Health Insurance Marketplace
    • Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value.
    • Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
    • Pay the share of premiums not covered by advance credit payments.