Penalty for Failure to Obtain Health Insurance
Massachusetts requires most adults 18 and over with access to affordable health insurance to obtain it. In 2019, individuals must be enrolled in health insurance policies that meet minimum creditable coverage standards defined in regulations adopted by the Commonwealth Health Insurance Connector Authority (Health Connector). Individuals who are deemed able to afford health insurance but fail to obtain it are subject to penalties In Massachusetts for each month of noncompliance in the tax year (provided that there is no penalty in ,the case of a lapse in coverage of 63 consecutive days or less). The monthly penalties, which will be imposed through the individual’s personal income tax return, are set out in Technical Information Release (TIR) 19-1 and are based on half of the minimum monthly insurance premium for which an individual would have qualified through the Health Connector.
Note: For tax years beginning on or after January 1, 2019, a taxpayer who does not have health insurance that meets the federal standard of minimum essential coverage will no longer be subject to the federal shared responsibility payment (federal healthcare penalty).
Schedule HC, Health Care Information, must be completed by all full-year and certain part-year residents age 18 and over to notify DOR whether or not they had health insurance for each month of 2019. Taxpayers who did not have coverage for all of 2019, or had a gap in coverage of four or more consecutive months will need to determine if they had access to affordable health insurance (through an employer, the government, or on their own) using worksheets and tables available for this purpose. If it is determined that a taxpayer could have afforded health insurance, the taxpayer has the right to appeal the application of the penalty due to hardship by requesting an appeal to the Connector on the Schedule HC.
For more information about the health care reform law, including the Department’s regulation at 830 CMR 111M.2.1, Health Insurance Individual Mandate; Personal Income Tax Return Requirements, or the Health Connector’s regulation at 956 CMR 6.00, Determining Affordability for the Individual Mandate, see the Health Connector’s website at mahealthconnector.org or the Department’s website at mass.gov/dor.