Do I have to enroll in healthcare benefits?

As part of the 2010 Patient Protection and Affordable Care Act (aka ACA or Obamacare), all Americans are required to have medical insurance. This is commonly called the "individual mandate." 

Through the end of the 2018 tax year:

  • There remains a tax consequence for not having medical insurance.  

Effective as of the 2019 tax year:

  • The Tax Cuts and Jobs Act (TCJA) of 2017 removed the ACA individual mandate tax consequences ("penalty"). 
  • The TCJA effectively "zeroed out the penalty."
  • It will likely take years for the courts determine how removing the tax consequences of the individual mandate will impact the core provisions of the Affordable Care Act.

Essential Benefits

The Affordable Care Act also defines benefits that must be included in health plans:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs. Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision care

Coverage Rights & Protections

The ACA includes these core consumer provisions:

  • Requires insurance plans to cover people with pre-exisiting conditions without charging more
  • Free preventive care
  • Ending lifetime & yearly limits
  • Child coverage through 26
  • View all Rights & Protections Under the ACA

Affordable Care Act (ACA)

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