As you’ve shopped for an Obamacare plan during open enrollment, you’ve probably determined your health insurance cost and potential subsidy amount for 2016. But what about the cost of going without coverage?
The cost of going without health insurance depends on factors such as what you will pay out of pocket if you need medical care and the tax penalty you could owe.
What is the Obamacare tax penalty?
Under the Affordable Care Act, most Americans are required to have health insurance that qualifies as minimum essential coverage. This requirement is called the individual shared responsibility provision, which is sometimes known as the “individual mandate.”
Those who go without ACA-compliant health insurance for more than a single period of up to three months may owe a tax penalty called the individual shared responsibility payment. For every month you go without health insurance and are not exempt, you will owe 1/12th of the annual payment.1
The 2016 penalty for not purchasing minimum essential coverage is the higher of these amounts:2
- 2.5 percent of your annual household income above the tax filing threshold to a cap of the national average bronze plan premium
- $695 per adult and $347.50 per child under 18 to a maximum penalty of $2,085 per family
The Obamacare tax penalty has increased annually since 2014, the first year individual shared responsibility provision took effect. A Kaiser Family Foundation analysis found that the average tax penalty for going without health insurance in 2016 will be $969—47 percent higher than the estimated average of $661 in 2015.3
Calculate your 2016 tax penalty amount
If you’ve been shopping for an Obamacare health insurance plan during open enrollment, you’ve probably calculated your estimated 2016 tax credit. Using the 2016 Health Insurance Cost and Subsidy Calculator at www.healthedeals.com, you can also estimate your tax penalty—the fee you would pay if you go without ACA-compliant health insurance coverage.
Of course, the true cost of going without health insurance could stretch beyond your estimated tax penalty. If you need healthcare while uninsured, you will be responsible for paying your medical bills out of pocket.
Considering the penalty over coverage?
As The New York Times recently reported, there are some consumers who believe the tax penalty is more affordable than health insurance coverage. However, experts caution that this decision can be a gamble.4
In addition to estimating their shared responsibility payment, you must consider what will happen if you or your family members have unexpected medical expenses and whether or not you are prepared to pay for them.
Speaking with a health insurance producer (i.e. agent or broker) can help you determine your options. If you are not eligible for premium tax credits or cost-sharing reductions, these professionals can help you explore on- and off-exchange coverage options that can potentially stretch your healthcare dollars and also prevent you from owing a penalty at tax time.