Am I Legally Required to Have Health Insurance?

Apr 2, 2024

Is it illegal to not have health insurance? What are the penalties for not having health insurance? These are just a few of the common questions about health insurance that you may have— the laws surrounding health insurance have changed so much in recent years, it can be hard to keep track. Let’s dive into some of the finer details to get a better understanding of the legal requirements surrounding health insurance!

The Origin of the Federal Mandate

Long story short, the answer is technically yes–you are required by federal statute to have health insurance, but there is zero penalty for not doing so. There is nuance to this answer, and it requires us to take a look back through the past few years to get to the bottom of it.

Signed into law on March 23, 2010, by President Barack Obama, the Affordable Care Act (ACA) has significantly impacted access to healthcare in the United States— expanding access and affordability to quality health care for millions of Americans. It also guaranteed issue coverage regardless of preexisting conditions, saw the expansion of Medicaid and the elimination of benefit maximums, and required employers with 50 or more full-time employees to provide health insurance to 95% of their full-time employees.

However, from 2014 to as recently as 2019, the Affordable Care Act required that people have health insurance that met certain standards. Failure to have the minimum coverage could result in tax penalties from the Internal Revenue Service (IRS), sometimes referred to as the Shared Responsibility Payment. These penalties could add up to $695 or 2.5% of your income per uninsured person, depending on which was higher. Congress repealed the financial penalty at the federal level in 2017, and it took effect in 2019. In response to the elimination of the prior mandate, a few states enacted their own version of the mandate, including state-level tax penalties.

Which states have an Individual Mandate?

These 6 states implemented their own version of the Affordable Care Act mandate to ensure healthcare is affordable for all residents. They believe that requiring health insurance will make it more affordable for everyone in the long run. The states that currently have a penalty for individual mandate are: 

  • California
  • District of Columbia (D.C.)
  • Massachusetts
  • New Jersey 
  • Rhode Island
  • Vermont

Why Having Health Insurance Matters.

Understanding your state’s health insurance laws is essential to avoid any potential penalties in the future. Life changes can bring unexpected changes, so being prepared and informed about health insurance is crucial!   

Currently, there are no tax penalties or fines for not having health insurance in Nevada. However, beyond the legal requirement, finding the right coverage offers the protection of a health insurance plan you can trust when/if you have a medical emergency! While it may seem like one less thing to worry about and pay for, not having health insurance can lead to facing financial burdens down the line if something comes up. In those moments, coverage can provide peace of mind in case a medical need arises amidst the changes in your life. Click here for 4 Reasons to Enroll in Health Insurance When You’re Young and Healthy.

There are many options for health insurance coverage, designed for people with varying needs. One of those is Nevada Health Link, Nevada’s health insurance marketplace, established in response to the Affordable Care Act, which has played a significant role in providing Nevadans with access to comprehensive and affordable health insurance options. Our health insurance marketplace empowers Nevadans to explore insurance plans, compare options, and enroll in coverage that fits their needs, largely contributing to the creation of a healthier and more resilient community that recognizes the importance of health care. 
If you’re a Nevadan looking for quality, affordable health insurance, click here to get started.