Is it illegal to not have health insurance?

Is there a federal penalty for having no health insurance?

No, the federal government does not charge a penalty today. Years ago, the Affordable Care Act taxed people who went without coverage. That penalty is now zero, and it has stayed at zero for several years. The IRS says the payment amount was reduced to zero for months beginning after December 31, 2018.

This means you do not owe the federal government anything for being uninsured. You also do not have to file the old form for it, which was called Form 8965. People without coverage for part or all of a year do not need to make a payment or file that form, according to the IRS.

Going without insurance is a legal choice at the federal level. It is still a risky one, because a single hospital stay can cost more than most families have saved. This page is general information and is not legal, tax or medical advice. In an emergency, call 911 or go to the nearest emergency room.

A few states still have their own penalty

A state can make its own rule, even though the federal penalty is gone. We checked the official websites for the places below, and each one requires coverage or charges a penalty. The money is collected when you file your state income tax return.

• California has required coverage since January 1, 2020. For the 2025 tax year, the state Franchise Tax Board lists the penalty as the higher of two amounts. One is $950 per adult and $475 per child. The other is 2.5 percent of your income above a filing threshold.
• Massachusetts has had a coverage rule for many years. The state says you are only penalized if you could afford insurance and did not buy it. People at or below 150 percent of the federal poverty level, which is a yearly income measure the government sets, are not penalized.
• New Jersey requires every resident to have coverage or make a payment. For the 2025 tax year, the state lists an individual payment range of $695 to $4,908.
• Rhode Island has required coverage since January 1, 2020. A gap of one or two months in a row carries no penalty.
• Washington, DC, requires residents to have coverage, get an exemption or pay a penalty on their DC taxes. DC Health Link lists $845 per adult for a full year without coverage in 2026.

These five are the places with a penalty that we could confirm on official state or DC sites. Vermont asks residents to report on their state tax return whether they had coverage each month, but Vermont Health Connect says there is no cash penalty for going without. Another state could add a rule later, so check your own state's tax agency if you live somewhere else.

State penalties come with exceptions

Every one of these places also offers some exemptions. An exemption is a reason the state agrees you do not owe the penalty. Common ones include having very low income or having a short gap in coverage.

Rhode Island says a gap of one or two months in a row carries no penalty. DC lists low income and less than three months without coverage as exemptions, and residents claim them on the DC tax return. New Jersey says people who are not required to file a state income tax return are automatically exempt.

Each state has its own forms and rules, and they change. Residents of these places should read their state's page or ask a tax preparer before filing.

Why people go without coverage

A monthly premium is the amount you pay every month to keep a plan active. A deductible is the amount you pay yourself each year before the plan starts to pay. For some families, both are too high to manage.

Others lose a job and a plan together, or work for themselves and have no employer to help. Some people live in a state that did not expand Medicaid, and they earn too much for Medicaid but too little for Marketplace help. Our guide on the Medicaid gap explains that situation. After a recent job loss, ask about a special enrollment period on HealthCare.gov.

Cheaper choices exist, and they can protect you from a big surprise bill.

What can you do if you are uninsured?

Start by checking whether you can get coverage cheaply or for free. Medicaid and the Children's Health Insurance Program, called CHIP, accept applications all year. HealthCare.gov says you can apply for them at any time. A Marketplace plan usually needs you to sign up during Open Enrollment. That period has started on November 1 in recent years. Sign-up is also open after a life event, such as losing other coverage, and HealthCare.gov lists the current dates.

If coverage is not possible right now, you can still get care at a fair price.

• Go to a community health center, which is a clinic that charges on a sliding scale based on your income. Read our guide on community health centers to learn how to find one.
• Look for a cash-pay doctor. Direct primary care is a monthly membership with a doctor that usually costs $50 to $200 a month. It is not insurance and does not pay hospital bills. Our directory lets you search for a cash-pay doctor near you.
• Ask for the cash price before any visit, test or medicine. Our guide on how to ask for the cash price has a phone script.
• Keep our guide on care without insurance handy for the next steps.

A hospital bill may still arrive one day, and our page on hospital financial assistance explains your options. Many nonprofit hospitals must have a written policy that reduces bills for people with lower incomes.