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James Cook
James Cook

What Happens If You Don T Buy Health Insurance

The Affordable Care Act initially required that nearly all Americans have health insurance or get hit with a tax penalty. Congress later eliminated the federal penalty, but some states have their own health insurance mandates.

what happens if you don t buy health insurance

Some people need special medical devices to treat their health conditions. For example, if you have sleep apnea, you might need a continuous positive airway pressure (CPAP) machine to help you breathe at night.

If you have health insurance, you probably have found yourself grumbling about all the costs you pay, including premiums, deductibles, copays and coinsurance. These costs are a bargain compared to what you might pay without insurance.

You could purchase a plan on the Affordable Care Act health insurance marketplace. An ACA plan generally costs more than an employer-sponsored group health insurance plan unless you qualify for subsidies that reduce the cost of ACA plans.

One way you can cut your costs is to purchase a high-deductible health insurance plan and pair your coverage with a health savings account, which offers tax incentives that can put more money back in your pocket. On the ACA marketplace, Bronze and Silver plans are often high-deductible health plans, which have lower premiums but higher out-of-pocket costs when you need care.

Another option is a special enrollment if you face a qualifying life event. Qualifying events include getting married, having a child, getting divorced or moving to a new state. You may be eligible for a special enrollment period to choose a new health insurance plan in those cases.

Without health insurance, you will be responsible for covering all health care costs, which could be financially ruinous. Health insurance can be affordable through an employer or a subsidized ACA marketplace plan.

Chris Kissell is a writer and editor whose work has been featured at Forbes, U.S. News & World Report, MSN Money, Fox Business, Forbes, Yahoo Finance, Bankrate, Money Talks News and more. He writes mainly about personal finance, insurance and health issues.

Thomas J Catalano is a CFP and Registered Investment Adviser with the state of South Carolina, where he launched his own financial advisory firm in 2018. Thomas' experience gives him expertise in a variety of areas including investments, retirement, insurance, and financial planning.

The coronavirus pandemic caused major economic and health care disruptions; however, unlike during previous downturns, the coverage expansions put in place by the Affordable Care Act (ACA) served as a safety net for people who lost jobs and access to health coverage. The ACA sought to address the gaps in our health care system that left millions of people without health insurance by extending Medicaid coverage to many low-income individuals and providing subsidies for Marketplace coverage for individuals below 400% of the federal poverty level (FPL). In addition, policies adopted during the pandemic, including the requirement that states maintain continuous enrollment for Medicaid enrollees and the enhanced subsidies in the Marketplace, protected people against coverage losses and improved the affordability of private coverage, making it easier for low-income individuals most affected by the pandemic to gain and retain coverage. As a result, after increasing for three straight years from 2017 to 2019, the number of nonelderly uninsured individuals dropped by nearly 1.5 million from 28.9 million in 2019 to 27.5 million in 2021, and the uninsured rate decreased from 10.9% in 2019 to 10.2% in 2021.

This issue brief describes trends in health coverage during the second year of the pandemic, examines the characteristics of the uninsured population in 2021, and summarizes the access and financial implications of not having coverage. Using data from the American Community Survey (ACS), this analysis compares health coverage data for 2021 to data for 2019; because of disruptions in data collection during the pandemic, the Census Bureau did not release 1-year ACS estimates in 2020.

Most of the nonelderly in the U.S. obtain health insurance through an employer, but not all workers are offered employer-sponsored coverage or, if offered, can afford their share of the premiums. Medicaid covers many low-income individuals; however, Medicaid eligibility for adults remains limited in some states that have not adopted the ACA expansion. With the Medicaid continuous enrollment requirement in place during the PHE, Medicaid coverage increased in many states. While financial assistance for Marketplace coverage is available for many moderate-income people, few people can afford to purchase private coverage without financial assistance.

Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy they are. While the COVID-19 pandemic affected health care utilization broadly, uninsured adults are far more likely than those with insurance to postpone health care or forgo it altogether because of concerns over costs. The consequences can be severe, particularly when preventable conditions or chronic diseases go undetected.

Largely due to policies put in place during the COVID-19 pandemic to stabilize coverage, the number of people without health insurance dropped in 2021. The coverage gains were driven primarily by increases in Medicaid coverage due to the continuous enrollment requirement that has been in effect since the start of the pandemic. The increases in Medicaid as well as smaller gains in nongroup coverage offset declines in employer coverage, leading to the drop in the number of uninsured and the uninsured rate. While the improvements in coverage were widespread, they were particularly large for Hispanic people, those in low-income families, and among people in working families, including those with only part-time workers in the family.

The end of the COVID-19 PHE could reverse these recent coverage gains. Once the PHE ends, which is expected sometime next year, states will resume Medicaid redeterminations and will disenroll people who are no longer eligible or who are unable to complete the renewal process even if they remain eligible. As a result, KFF estimates that between 5 and 14 million people could lose Medicaid coverage, including many who newly gained coverage during the pandemic. Recent funding increases for Navigators and other efforts to increase outreach and the availability of enrollment assistance can help people complete the Medicaid renewal process, and if found no longer eligible, transition to other coverage. The continued availability of the enhanced Marketplace subsidies will make that coverage more affordable for people who are disenrolled from Medicaid and may increase the share of people who successfully transition from Medicaid to Marketplace coverage. Still, any large increase in the number of people who are uninsured could undermine improvements in access to care and financial stability that come with having health coverage and could worsen disparities in health outcomes.

The Massachusetts Health Care Reform Law requires that most residents over 18 who can afford health insurance have coverage for the entire year, or pay a penalty through their tax returns. Penalties add up for each month you don't comply, but there is a grace period that allows lapses in coverage of 3 or fewer consecutive months. You must be enrolled in health insurance plans that meet Minimum Creditable Coverage (MCC) requirements.

You may also buy plans through approved Massachusetts health insurance carriers. To learn more or buy a plan, contact the Health Connector at (877) 623-6765, TTY number at (877) 623-7773, or visit the website.

Whether or not you have to file a Massachusetts personal income tax return, anyone 18 years old or over must get and maintain creditable health insurance coverage as long as it's considered affordable under the schedule set by the Massachusetts Health Connector. This includes those who are exempt from filing taxes. This health care mandate applies to:

If you're a resident, or in some cases a part-year resident, file Schedule HC with your Form 1 or Form 1-NR/PY. If you don't, this will delay processing your return. Fill in the Health Care Information section on your Schedule HC to prove that you have health insurance that meets MCC requirements.

If you have health insurance from more than 2 insurance carriers, fill out Schedule HC-CS as well. Report your 2 most recent insurance carriers first on Schedule HC first and then fill out Schedule HC-CS to report your additional insurance carriers.

Your health care premiums are tax-deductible if you're self-employed, so you can reduce your taxable income by your health insurance premium's cost. This is reported on Schedule Y of your Massachusetts income tax return. The Massachusetts Health Connector offers health plans on a pre-tax basis.

If you moved into Massachusetts during the year, the health care mandate applies to you beginning on the first day of the third full month following the month you became a Massachusetts resident.

If your plan doesn't meet the MCC requirements for the entire time that the mandate applied to you, fill in the "No MCC/None" oval in line 3 of the Schedule HC. You won't be penalized if we determine that you didn't have access to affordable insurance that met MCC.

Most plans meet the MCC standards. You'll know if your plan does because Massachusetts-licensed health insurance companies must put an MCC-compliance notice on their plans to indicate if it does or doesn't meet MCC.

If you receive a Form MA 1099-HC from your insurer, it will indicate whether your insurance meets MCC requirements. If you didn't receive one from your insurer and get health coverage through your job, you can call your insurer or your employer's human resources department or benefits administrator for help. If your insurer or your employer can't help you, please refer to list of benefits above to see if your policy meets these requirements. If your plan meets all of the requirements listed above, you may certify that you were enrolled in a plan that met the MCC requirements during that time period. 041b061a72


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