There is no federal tax penalty for not having health insurance, and there hasn’t been one since the 2019 tax year. But if you live in California, Massachusetts, New Jersey, Rhode Island, or the District of Columbia, your state charges its own penalty when you go without qualifying coverage. Vermont technically requires coverage but does not attach a fine. Everywhere else, being uninsured costs you nothing at tax time.
Why the Federal Penalty Went Away
The Affordable Care Act’s individual mandate, codified at 26 U.S.C. ยง 5000A, once required nearly everyone to carry health coverage or pay a “shared responsibility payment.”1Office of the Law Revision Counsel. 26 USC 5000A – Requirement to Maintain Minimum Essential Coverage The Tax Cuts and Jobs Act of 2017 reduced that penalty to $0 for all tax years beginning after December 31, 2018. The requirement is still in the federal code, but the IRS collects nothing for it, and you no longer file Form 8965 to claim an exemption.2Internal Revenue Service. Questions and Answers on the Individual Shared Responsibility Provision
When the federal penalty disappeared, several states created their own mandates to keep healthier residents from dropping coverage and driving up premiums for everyone else.
States That Still Charge a Penalty
Five states plus DC enforce a financial penalty for going uninsured: California, Massachusetts, New Jersey, Rhode Island, and the District of Columbia. Vermont has a mandate but confirms on its state exchange that “you don’t have to pay a fine if you don’t have health coverage.”3Vermont Health Connect. Health Insurance Requirements Residents of any other state owe nothing for being uninsured.
Most of these mandates work the same way. You calculate two figures: a flat dollar amount per uninsured person in your household, and a percentage of household income above the tax filing threshold. Whichever is larger becomes your penalty, capped at roughly the cost of a Bronze marketplace plan for a household your size. Massachusetts is the exception; it uses a sliding scale tied to the Federal Poverty Level instead.
California
For the 2025 tax year (filed in spring 2026), California charges $950 per uninsured adult and $475 per uninsured child, or 2.5% of household income above the filing threshold, whichever is higher.4Franchise Tax Board. Personal Health Care Mandate A married couple with two uninsured children faces a flat penalty of $2,850 before the income calculation even enters the picture. The penalty is prorated by month, so partial-year coverage reduces what you owe. You report exemptions and calculate the penalty on Form 3853, which flows onto your Form 540.5Franchise Tax Board. 2024 California Form 3853 Health Coverage Exemptions and Individual Shared Responsibility Penalty
Massachusetts
Massachusetts uses a sliding scale based on your income as a percentage of the Federal Poverty Level. At or below 150% of FPL, you owe nothing. Above that, monthly penalties for 2025 run from $25 at the lower end to $187 for individuals earning more than 500% of FPL, a maximum annual penalty of $2,244.6Massachusetts Health Connector. Massachusetts Individual Mandate
The penalty only applies after four or more consecutive months without coverage that meets Massachusetts’ “Minimum Creditable Coverage” standard. That standard is stricter than the federal definition, so some plans that satisfy other states’ mandates fall short here. You report coverage on Schedule HC with your state return.7Mass.gov. 2025 Massachusetts Schedule HC Instructions
New Jersey
New Jersey follows the original federal formula closely. For 2025, the flat amount starts at $695 per uninsured adult, with a maximum of $4,908 for an individual.8State of New Jersey. NJ Health Insurance Mandate – Shared Responsibility Payment Children are charged at half the adult rate. The alternative calculation is 2.5% of household income above the filing threshold, and you owe the larger figure, capped at the statewide average Bronze plan premium for your household size.
You report the amount on NJ-1040 using Schedule NJ-HCC. If your income is at or below $10,000 (single) or $20,000 (other filing statuses), you automatically owe no penalty.9nj.gov. NJ-1040 Shared Responsibility Payment Instructions Unpaid shared responsibility payments accrue the same interest and late-payment charges as any other state income tax debt.8State of New Jersey. NJ Health Insurance Mandate – Shared Responsibility Payment
Rhode Island
Rhode Island’s 2025 flat penalty is $57.92 per month for each uninsured adult and $28.96 per month for each uninsured child under 18, or roughly $695 and $348 annually. The income-based alternative is 2.5% of income above the standard deduction. The Bronze plan cap runs from $4,284 for a single person up to $21,420 for households of five or more.10RI Division of Taxation. 2025 Individual Mandate Penalty Worksheet
District of Columbia
DC’s mandate took effect in 2019 and mirrors the original federal structure: a flat dollar amount per person or 2.5% of income above the filing threshold, whichever is larger, with base amounts adjusted annually for inflation.11DC Health Benefit Exchange Authority. IRS Health Care Tax Penalty The charge appears on your DC income tax return.
Exemptions That Cancel the Penalty
Every mandate state recognizes exemptions that remove the penalty even when you were uninsured. Categories vary but generally include:
- Affordability. If the cheapest available coverage would have cost more than a set percentage of household income, you’re exempt. The 2026 federal affordability threshold for employer-sponsored coverage is 9.96% of income; state thresholds follow similar logic.
- Income below the state filing threshold, which usually triggers an automatic exemption.
- A short coverage gap of fewer than three consecutive months, usable only for the first such gap in a tax year.
- Financial hardship, including eviction, bankruptcy, domestic violence, or a natural disaster.
- Religious conscience for members of recognized groups that decline insurance benefits.
- Tribal membership or eligibility for services through Indian Health Services.
- Membership in a qualifying health care sharing ministry.
Some exemptions come through a checkbox or short form on your state return. Others, especially hardship exemptions in Massachusetts, require you to apply for a certificate through the state marketplace before you file.12Massachusetts Health Connector. What to Do if You Did Not Have Health Coverage for Part or All of 2025 Check early if you think you qualify.
Short Coverage Gaps
The mandate states generally treat a gap of fewer than three consecutive months as exempt from penalty. Coverage for even a single day in a month counts that whole month as covered. A gap of three months or longer, though, loses the exemption entirely; every month of that stretch is penalized.
Two short gaps in the same year is another trap. Only the first one qualifies for the exemption. The second gap gets penalized in full, which matters if you change jobs twice in a year and have brief uninsured stretches each time.
Moving To or From a Mandate State
If you move partway through the year, the penalty applies only to the months you were a resident of the mandate state without coverage. New Jersey calculates penalties monthly and counts only months of New Jersey residency.13State of New Jersey. Claim Exemptions Massachusetts limits its mandate the same way.
Moving is also a qualifying life event that opens a 60-day Special Enrollment Period in your new state. If you’re relocating to a mandate state, use that window rather than waiting for the next open enrollment, or you’ll accumulate penalty months in the meantime.
Getting Covered Before the Next Filing Season
Open enrollment for 2026 marketplace coverage runs from November 1, 2025, through January 15, 2026, in states using HealthCare.gov. Coverage starting January 1 requires signing up by December 15, 2025. California, New Jersey, Rhode Island, and DC extend enrollment through January 31; Massachusetts allows enrollment through January 23.
Outside open enrollment, a Special Enrollment Period opens after a qualifying life event: losing existing coverage, getting married, having a baby, or moving to a new state.14HealthCare.gov. Special Enrollment Periods for Complex Health Care Issues You have 60 days from the event to enroll. If none of those apply and you’re uninsured now, your next chance is the following open enrollment, and every month in the meantime is another billable month if you’re in a mandate state.