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How Much is the Penalty for No Health Insurance?

Which States Still Charge a Penalty?

As of the most recent filing year, these states have their own individual mandate penalties:

  • California
  • New Jersey
  • Rhode Island
  • Massachusetts
  • Vermont (mandate exists, but penalty not enforced)
  • Washington, D.C.

These penalties are collected through your state tax return, not the federal return.

How Much Are the Penalties in These States?

Each location calculates it differently.
Here are the most common models:

Percentage of income

Some states charge a percentage of your household income, similar to the original federal ACA penalty structure.

Flat penalty per person

Others charge a flat amount per uninsured adult and child.

Combination formula

Most states charge whichever is higher:
a percentage of income OR a dollar amount.

In many cases, the penalty can easily reach hundreds of dollars.

Example: California

California’s penalty can be:

  • a percentage of household income, or
  • a flat amount

For many households, the calculation comes out between $800 to $2,500, depending on dependents and income.

Why Some People Are Surprised

Many taxpayers assume that because the federal penalty is gone, nothing applies.
Then they file and suddenly owe a large amount on their state return, especially families with multiple dependents.

Who Avoids the Penalty?

Most states include exemptions including:

  • low-income households
  • unaffordable coverage (based on income percentage)
  • short gaps in coverage (usually less than 3 months)
  • certain hardships
  • Medicaid-eligible taxpayers

But these exemptions must be claimed properly on the state tax form.

What About Federal Tax Refunds?

The penalty does not affect federal refunds.
It only reduces or balances against your state tax refund, or increases the amount you owe the state.

How To Protect Yourself

To avoid state penalties:

  1. Check whether your state imposes a penalty
  2. Review income-based exemptions
  3. Use the HealthCare.gov marketplace to compare low-cost plans
  4. Look at Medicaid eligibility based on your state’s rules

Even a low-cost Bronze plan may eliminate a high penalty amount.

If You Live in One of These States, Pay Attention

If you are in:

  • CA
  • NJ
  • MA
  • RI
  • DC

your state likely expects health coverage proof.

If you ignored insurance last year, be prepared for a debit or a reduced state refund.

There is no federal penalty, but several states now require coverage and enforce their own fines.
For many families, the penalty can be higher than the cost of a low-tier plan.

Before filing, check your state’s rules. It could save you a lot of money at tax time.

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