Affordable Care Act Penalty Exemptions

Affordable Care Act Penalty Exemptions


The Affordable Care Act has been in place for five years and it is time to assess penalties. However, the law has many exemptions that let people opt out and not have to pay a penalty. Those who qualify will be exempt from paying any penalty.

On March 23, 2010, The Affordable Care Act became effective. This meant that all citizens are now required to pay a penalty if they do not have a qualifying exemption, this “penalty” is referred to as a shared responsibility payment. This round of penalties will be taken from 2014 tax returns. Here are many of the exemptions people may qualify for to escape paying the penalty.

Affordable Care Act Exemptions:

  • Income lower than federal filing threshold
  • Unpaid medical expenses in past 24 months
  • Received disconnection notice from a utility company
  • Home damaged by flood, fire, or any other natural disaster in last year
  • Sudden rise in expenses in past year due to having to care for an ill, disabled or aging family member
  • Filed bankruptcy in past six months
  • Homeless in last year
  • In jail in last year
  • Victim of domestic violence in past year
  • Passing of close family member in last year
  • Served in AmeriCorps State National, VISTA or NCCC
  • Were outside the U.S. a minimum of 330 days in a 12 month period
  • Eviction or foreclosure
  • Have TRICARE or Medicaid
  • Will claim child as tax dependent who has been refused coverage in Medicaid and CHIP program and someone else has been court ordered to medically support child
  • Current health insurance being canceled and other plans are not affordable
  • Religious objections to insurance as a member of religious sect recognized by the Social Security Administration
  • Rendered unqualified for Medicaid in a state that refused to expand Medicaid coverage
  • Household income 138 percent below poverty line for family size
  • Experienced hardship preventing you from getting coverage under qualified health plan
  • Minimum amount required to pay is more than eight percent of total household income
  • Member of health care sharing ministry
  • Member of Indian tribe recognized by the federal government, Corporation Shareholder (regional or village) including an Alaska Native Claims Settlement Act (ANCSA), or eligible for services through an Indian Health Services provider

You can go to for a complete listing of all exemptions from the Affordable Care Act penalty. There are many new regulations, but if you did not have insurance coverage for any of 2014, these exemptions are provided by the Act. The point of the Act was to be truly affordable.

The Affordable Care Act (ACA) can be confusing to understand. Also there are many rumors swirling around that make it even more difficult to understand.

The Affordable Care Act only requires business with 50 or more employees to provide health coverage to their employees. Any business that has 49 or less employees are offered large tax incentives, of up to 50 percent of the business costs to buy health coverage for their employees. However, it is not required. 96 percent of small businesses have less than 50 employees and are exempt. Also, since the Affordable Care Act became a law, there are 10.5 million more jobs today.

The Affordable Care Act is not causing premiums to rise. In December 2014, the average premium had not changed and the average deductible has only increased by one percent. Considering the increases between 2008 and 2010 in the individual market, averaging ten percent, this statistic is amazing.

The Affordable Care Act is using free markets and total transparency to distribute health care to more people. Those who want to purchase policies on the marketplaces can buy from private insurance companies. The Affordable Care Act has nothing to do with medical providers and individual patients, it just helps to provide coverage. There are basics that each insurance policy has to provide, according to the Affordable Care Ace, such as prescription medications, visits to the emergency room and medical care before and after a baby is born. You can find out more about the basics at

The Affordable Care Act’s goal is to help as many Americans as possible and to make sure everyone has healthcare coverage, not just minorities and the unemployed. The Affordable Care Act is currently serving more than 60 percent white, non-Hispanics living in the South. 80 percent of those benefiting from the Affordable Care Act are working.

The Affordable Care Act is slowing the growth of the Medicare program to save money between 2013 and 2022 but this is affecting beneficiaries by reducing over-payments to insurance companies, hospitals and doctors. Before the Affordable Care Act, private insurance companies that conduct the Medicare Advantage plans have been getting an average of 14 percent more for the same services as regular Medicare. Also, the Affordable Care Act improved the coverage of prescription drugs under Medicare Part D. It did so by closing the coverage gap in the law and it now provides free preventative services to seniors on Medicare.

There are an abundance of people that believe requiring Americans to have health coverage is unconstitutional. The U.S. Supreme Court ruled the Affordable Care Act constitutional. A provision of the law, the individual mandate, has been ruled allowed under the Constitution. The law requires that most people have health coverage or pay a penalty.

When as many people as possible are in the insurance pool, healthy and unhealthy, insurance can be at its best. If there was not a requirement to buy insurance, improvements to the Affordable Care Act, like not allowing insurance companies to deny people due to pre-existing conditions, would not work without them paying high premiums.

By Jeanette Smith




Photo courtesy of Lesley Looper – Flickr License


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