Affordable Care Act penalties

Beginning January 1, 2014, the Affordable Care Act requires all Americans to have minimum essential health coverage, qualify for an exception, or pay a tax penalty. The penalties are phased in, according to the following schedule:

  • 2014 – $95 per uninsured adult and $47.50 per uninsured child (capped at $285 per household) or 1% of the household income, whichever is greater.
  • 2015 – $325 per uninsured adult and $162.50 per uninsured child (capped at $975 per household) or 2% of the household income, whichever is greater.
  • 2016 and beyond – $695 per uninsured adult and $347.50 per uninsured child (capped at $2,085 per household) or 2.5% of the household income, whichever is greater.

Most individuals in the United States have health coverage today that will count as minimum essential coverage and will not need to do anything more than continue the coverage that they have. For those who do not have coverage, who discontinue the coverage they currently have, or who want to explore other affordable options, health insurance Marketplaces (formerly called exchanges) will open in every state in 2014. These exchanges will help qualified individuals find minimum essential coverage that fits their budget and look for potential financial assistance to help with the costs of coverage and will open for 2014 enrollment on October 1, 2013.


Exceptions to the mandate may apply to the following:

  • Those with religious objections
  • Incarcerated individuals
  • American Indians
  • Those for whom the lowest-cost health coverage  is more than 8 percent of household income
  • Undocumented immigrants
  • Those with incomes below the filing threshold

Changing Premiums

Premium rates are likely to change for many people. New mandated coverage (including expanded mental health and maternity benefits) will put upward pressure on rates.  So will the influx into the Individual market of those who were previously uninsurable or covered by government high-risk pools.  On the other hand, those who qualify for new federal subsidies and those who previously had high costs may see a reduction in their premiums.

The new federal subsidies will be available to qualified individuals who purchase health coverage through the Marketplace. To see if you may qualify for a subsidy, visit

*PLEASE NOTE: This is not a legal document and is intended for informational purposes only. We have attempted to provide the most accurate information possible, but Idaho Insurance Agency makes no guarantee regarding its accuracy or completeness.

Paul King and Charlotte Hildebrandt
1650 Albright Ln #101
Boise, Idaho 83709


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Address: 1650 S Albright, Boise, ID 83709


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