They ask for health insurance information from taxpayers who received advance subsidies when they enrolled in a Marketplace health insurance policy. Those advance credits have to be reconciled on your tax return. So, not everyone has to provide insurance information, but those that had ACA Marketplace policies will receive a Form 1095-A. The IRS can't process your return without it. @SammySeawead2020
If you purchased health insurance through Healthcare.gov or your state's health insurance marketplace, you will receive a Form 1095-A whether or not you chose to receive advance premium discounts for the Premium Tax Credit. It should include info for everybody on your return who was enrolled in a Marketplace plan during the tax year.
Unlike the 1095-B and 1095-C, you need to enter this form. You won't be able to take the Premium Tax Credit without it.
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