Health Insurance

Is It Mandatory To Have Health Insurance in 2022?

Alexis Bryan
Alexis Bryan11 Apr 2022

Since 2019, the Affordable Care Act (ACA) has not had a federal individual mandate penalty for the uninsured, which will remain in 2022. Four states and DC will impose a tax penalty on those who do not have health insurance.

State-Imposed Health Insurance Coverage Mandates

The federal penalty for not having health insurance (the individual mandate) was repealed in 2019. Still, states can impose tax penalties on their residents. Generally, the penalty applies to people who decide to go without health insurance but can afford it.

The state penalties are similar to the ACA individual mandate of 2018. The state individual mandate tax is based on the tax year, not the calendar year. It is paid when you file your taxes. The table below shows the tax penalties for 2022 in each state.

Tax Penalties for Those Who are Uninsured by State

StateTax Penalty
Massachusetts
  • No penalty if your income is less than 150% of the poverty level
  • 50% of the premium for the lowest-cost ConnectorCare plan if your income is between 150.1-300% of the poverty level
  • 50% of the cost of the lowest-cost bronze plan available through the Massachusetts Health Connector if your income is over 300% of the poverty level
New Jersey
  • Depends on household income and family size
  • The maximum penalty the average cost of a bronze plan in New Jersey
  • In 2020 the minimum tax penalty was $695 and the maximum was $3,012
California
  • $750 per uninsured adult and $375 per uninsured adult or 2.5 percent of household income (whichever amount is greater)
  • Maximum penalty equal to the average premium for a bronze level plan in CA (does not apply if that premium exceeds 8.28% of household income)
Rhode Island
  • $695 per uninsured adult and $347.50 per child or 2.5 percent of income (whichever amount is greater)
  • Up to a maximum of $2,085 per family
  • The maximum penalty will be equal to the cost of the average bronze plan in Rhode Island
District of Columbia
  • $695 per uninsured adult and $347.50 per child or 2.5% of household income (whichever amount is greater)
  • The maximum penalty is the average cost of a bronze plan in DC ($3,448 in 2020)

Health Insurance Penalty Exemptions

The main exemption from the state-level individual mandate is the affordability exemption. If the least expensive plan premium is greater than around 8% of your household income in 2021, there is no tax penalty for being uninsured.

There are several other exemptions which include:

  • Low income (below 138-150% of the federal poverty level)
  • Religious conscience exemption
  • Hardship exemption: homelessness, eviction, natural disaster, domestic violence, bankruptcy, or other disrupting life events
  • Short coverage gap (three months or less)
  • Part of a federally recognized Native American tribe

You can file for a hardship exemption here. To find out more about state-specific exemptions, you can visit the state website:

Massachusetts

New Jersey

California

Rhode Island

Washington DC.

Open Enrollment for Health Insurance in 2023

Open enrollment is when you can enroll in a health insurance plan through the Marketplace. Coverage begins the first day of the month after you sign up. The open enrollment period for health insurance coverage in 2022 ended on January 15, 2022.

For states that use the federal Affordable Care Act (ACA) exchange, the 2023 open enrollment period (OEP) begins November 1, 2022 and ends December 15, 2022 in most states. States may have different date ranges. 

Tentative Open Enrollment 2023 Dates

November 1, 2022: Open Enrollment begins

December 15, 2022: Open Enrollment ends (extensions may be granted)

January 1, 2023: Earliest health insurance plan start date

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Special Enrollment Period

Various qualifying events allow you to obtain coverage during the Special Enrollment Period. You can be granted 60 or 90 days to enroll in a plan with proof of a qualifying life event. Qualifying life events include:

  • Losing health coverage
  • Moving
  • Getting married or divorced
  • Having a baby
  • Adopting a child
  • Becoming a United States citizen

Alternatives to Health Insurance Through the Exchange

Health insurance premiums are often expensive and out of reach for many who need access to affordable care. Since there are no penalties for being uninsured in 2022, many seek health coverage elsewhere. Fortunately, there are alternatives to traditional health insurance plans.

Short Term Health Insurance

During the COVID-19 pandemic, many people have gone through transitional periods and have had a lapse in health care coverage. Short-term health insurance can be a temporary option to protect you from expensive medical bills. You are eligible for short-term coverage if you:

  • Change jobs
  • Lose employer-sponsored coverage
  • Are you waiting for the annual Open Enrollment Period
  • Attend out-of-state college
  • Other specific instances

Health Insurance Alternatives

A care membership program is another form of health benefit. These are often less expensive and easier to enroll in than traditional health insurance plans. Mira is an alternative to health insurance that helps you access affordable essential services like urgent care centers and lab testing.

Open Enrollment 2022 for Health Insurance Plans Frequently Asked Questions (FAQs)

Open enrollment for 2022 health insurance has passed, but it is crucial to seek health care coverage in other ways. While you are not mandated to have health insurance, there are important considerations when opting out of health insurance.

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Will my current ACA health insurance plan automatically renew?

If you are already enrolled in a health insurance plan through your state’s Marketplace, your plan will automatically renew if available for the following year. Those who live in Maine, Kentucky, and New Mexico will need to claim their new accounts as those states transition away from Healthcare.gov, but auto-renewal is an option for all other enrollees. 

Even if you are satisfied with your current plan, auto-renewal is not always the best option. During open enrollment, you should shop around to see if a health insurance plan better suits your needs for three main reasons.

  1. You are Locked In. If you do not change your current plan, you will be automatically enrolled in the same plan on the last day of open enrollment (December 15 in most states). This means you will not have a chance to change your mind later.
  2. Subsidies Change Year to Year. Another thing to consider is the amount of your subsidy. Subsidies change year to year, which could result in a higher premium for you and your family. If you browse around for other plans, you could save a substantial amount of money.
  3. If your plan is discontinued, auto-renewal will result in the exchange or your insurer picking a new plan. There is no guarantee you will be enrolled in a similar plan as the one you were previously enrolled in. They will try to assign you the closest plan, but again, there is no guarantee.

When is Open Enrollment 2023?

Open enrollment for 2023 health insurance is scheduled for November 1, 2022-December 15, 2022. Before it is time to enroll in a health plan, review your options. It is also important to check alternative plans for next year, even if you are currently enrolled.

How do I enroll in a health insurance plan during open enrollment?

You can enroll in a health insurance plan online, over the phone, or in person. To enroll, you will need the following information:

  • Name, address, email address, social security number, birthday, and proof of citizenship status
  • Household size and income if you want to apply for subsidies (to prove your income, you can provide pay stubs, W2s, your most recent tax return, etc.)
  • Coverage details and premium for an employer-sponsored plan that’s available to anyone in your household
  • Payment information for your premiums
  • Your doctors’ names and zip codes so that you can check to make sure they’re in-network
  • A list of medications taken by anyone who will be covered under the policy (to make sure the new plan covers them)
  • If you want to enroll in a catastrophic plan and are 30 or older, you’ll need a hardship exemption.

Bottom Line

There are no federal mandates for health insurance in 2022 or tax penalties in most states. Few states have enacted penalties for the uninsured, including Massachusetts, New Jersey, Rhode Island, California, and Washington DC.

Regardless of whether your state has a penalty, it is a good idea to have health coverage, whether through a traditional health insurance plan, short-term coverage, or an alternative option like Mira.