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What health care penalty exemptions are there for financial hardships?

The 2017 Tax Cuts and Jobs Act (also known as tax reform) eliminated the Affordable Care Act penalty starting in tax year 2019. The ACA penalty still applies to 2016, 2017, and 2018 returns.

If one of the following hardships kept you from getting health insurance in 2016, 2017, or 2018, you can apply for a penalty exemption before you file your taxes. If approved, you'll qualify to get back all or some of your penalty.

Healthcare.gov has instructions on how to apply for a hardship exemption.

You may qualify if you had any of the following hardships:

  • You were homeless.
  • You were evicted or were facing eviction or foreclosure.
  • You received a shut-off notice from a utility company.
  • You experienced domestic violence.
  • You experienced the death of a family member.
  • You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  • You filed for bankruptcy.
  • You had medical expenses you couldn't pay that resulted in substantial debt.
  • You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
  • You claim a child as a tax dependent who’s been denied coverage for Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case you don't have to pay the penalty for the child.
  • As a result of an eligibility appeals decision, you're eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace in 2018.
  • You were determined ineligible for Medicaid because your state didn't expand eligibility for Medicaid under the Affordable Care Act.
  • Your "grandfathered" individual insurance plan (a plan you’ve had since March 23, 2010 or before) was canceled because it didn't meet the requirements of the Affordable Care Act and you believe other Marketplace plans were unaffordable.

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