While the federal government dropped its individual mandate penalty in 2019, five jurisdictions still enforce financial penalties for going without health insurance.
Residents of California, Massachusetts, New Jersey, Rhode Island, and Washington, DC must either carry qualifying coverage or pay a “shared responsibility payment” when filing state taxes-unless they qualify for an exemption.
Penalties are typically the greater of a flat fee or a percentage of income, capped at the cost of the lowest-tier health plan available through state exchanges.
In California, the 2025 penalty is $950 per adult or 2.5% of gross income above the filing threshold-whichever is higher. A family of four could owe $2,850 or more.
Massachusetts uses income-based fines tied to ConnectorCare or bronze plan premiums. New Jersey’s penalty ranges from $695 to nearly $5,000 annually per adult, depending on income.
Rhode Island charges $57.92 monthly per adult or 2.5% of modified income over the state threshold. Washington, DC levies $795 per adult per month-or 2.5% of family income above the federal filing limit.
Experts warn that penalties often approach or exceed the cost of basic bronze or catastrophic plans. "A doctor’s visit plus the penalty likely costs more than minimal insurance," said CPA Miklos Ringbauer.
Exemptions exist for financial hardship, short coverage gaps (under three months), or if premiums exceed a set share of household income. State-run exchanges in these regions may offer subsidies to offset costs after federal aid expired.