5 min read·Updated Jan 2026

States with Health Insurance Mandate (2026)

The federal individual mandate penalty was eliminated in 2019. However, 6 states and DC have enacted their own mandates with financial penalties for being uninsured.

6 + DC

States with penalties

1

State with no enforcement (Vermont)

44

States with no mandate

States with penalties for being uninsured

Penalty: 2.5% of household income or $900/adult, $450/child (whichever is higher)
Exemptions: Income below filing threshold, hardship, religious

District of Columbia

Official site →
Penalty: 2.5% of household income or $745/adult (whichever is higher)
Exemptions: Income below filing threshold, hardship

Massachusetts

Official site →
Penalty: Varies by income — up to 50% of the cheapest available premium
Exemptions: Income below 150% FPL, hardship, religious
Penalty: 2.5% of household income or $695/adult, $347.50/child (whichever is higher)
Exemptions: Income below filing threshold, hardship, religious

Rhode Island

Official site →
Penalty: 2.5% of household income or $695/adult, $347.50/child (whichever is higher)
Exemptions: Income below filing threshold, hardship, religious
Penalty: No financial penalty — mandate exists but no enforcement mechanism
Exemptions: N/A

States with no individual mandate (45)

These states have no state-level penalty for being uninsured. However, being uninsured still carries significant financial risk from unexpected medical costs.

AlabamaAlaskaArizonaArkansasColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWest VirginiaWisconsinWyoming

What counts as qualifying coverage?

To avoid a penalty in states that have mandates, your coverage must generally qualify as Minimum Essential Coverage (MEC):

  • ✅ Employer-sponsored health insurance
  • ✅ ACA Marketplace plans
  • ✅ Medicare (Parts A, B, C, or D)
  • ✅ Medicaid and CHIP
  • ✅ TRICARE
  • ❌ Short-term health insurance (generally does NOT qualify)
  • ❌ Dental/vision-only plans
  • ❌ Fixed indemnity plans

How to avoid a penalty

1. Enroll in qualifying coverage during Open Enrollment (Nov 1 – Jan 15) or a Special Enrollment Period

2. Apply for an exemption if you qualify (hardship, religious, income below filing threshold)

3. Check Medicaid eligibility — if you qualify, Medicaid is free and counts as qualifying coverage

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