Skip to content

Many Categories Exempt From Individual Mandate

The Obama administration and Congress exempted many Americans from the health insurance law’s individual mandate. Those people who are either not required to have coverage or are automatically considered to have met the requirement include:

Members of a religious sect that is recognized as conscientiously opposed to accepting any insurance benefits.

Members of a federally recognized health sharing ministry.

Members of a federally recognized Indian tribe or someone eligible to get services from an Indian care provider.

People with income below the minimum threshold for filing a tax return. They won’t have to file a return just to show they are exempt from the mandate. The need to file a federal return depends on filing status, age and income.

Those without coverage for less than three consecutive months in a year. One coverage gap exemption per year is allowed.

Someone who suffered a hardship, under federal definitions, that made him or her unable to get coverage. The list includes people who became homeless, faced financial or domestic problems, filed bankruptcy in the past six months, would have to forgo basic needs to buy health coverage, experienced the death of a close family member, got a shut-off notice from a utility company, experienced a fire or other serious disaster, suffered from domestic violence, or many other situations.

People who can’t afford coverage because the lowest insurance premium is more than 8 percent of their household income.

Someone in a jail, prison or correctional facility after conviction.

Individuals born overseas who are not citizens or in the nation legally.

People whose health plan year started in 2013. For the first year of the program, people whose health plan years are not tied to the calendar year and whose plan year started in 2013 are exempt until the 2013-14 health insurance plan year ends. For instance, if your company’s policies renewed in July 2013 but you and your spouse didn’t sign up, you’re exempt until the new plan term starts the following July.

American citizens who are not in the United States for at least 330 days within a 12-month period, or citizens who are legal residents of a foreign nation for a full year. They are counted as having met the requirement.

Recent Stories

Total eclipse of the Hart (and Russell buildings) — Congressional Hits and Misses

House plans to send Mayorkas impeachment articles to Senate on Tuesday

Harris sticks with Agriculture spending, Amodei likely to head DHS panel

Editor’s Note: What passes for normal in Congress

House approves surveillance authority reauthorization bill

White House rattles its saber with warnings to Iran, China about attacking US allies