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ACA/Healthcare Reform

What is the tax penalty if an individual does not have health insurance? Is the penalty amount per month or per year?

The annual penalty amount is either a percentage of household income in excess of the return filing threshold or a flat dollar amount, whichever is greater.


Annual Penalty Amount for 2016


Flat dollar amount               

$695 per adult

$347.50 per child

Family maximum: $2,085

Note:  After year 2016, the flat dollar amounts are based on the 2016 amounts plus an inflation adjustment.


Percentage amount              

2.5% of household income above filing threshold


Household Income:  The modified adjusted gross income of you, your spouse (if filing jointly), and any dependents who are required to file a tax return.  Modified adjusted gross income is the adjusted gross income from the tax return plus any excludible foreign earned income and tax-exempt interest received during the taxable year.


Filing Threshold: The minimum amount of gross income an individual of your age and with your filing status (e.g., single, married filing jointly, head of household) must make to be required to file a tax return.


The penalty amount is capped at the cost of the national average premium for a bronze level health plan available through the Marketplace. For 2015, the annual national average premium for a bronze level health plan available through the Marketplace is $2,484 per year ($207 per month) for an individual and $12,240 per year ($1,020 per month) for a family with five or more members.


The penalty is for each month of noncompliance, however, the amounts indicated are per year. Hence, if an individual had coverage or an exemption for part of the year, the penalty amount is divided by 12 to get the monthly penalty amount.