Guide to Exemptions for the California Health Insurance Mandate

October 19, 2020 
Author : Melanie L. Miller

According to the California health insurance mandate put into place at the beginning of the year, every adult and child in the state must carry medical coverage compliant with the Affordable Care Act (ACA). Despite the goal to insure 100% of the CA populace, exemptions exist for a variety of reasons.

Ideally, everyone has coverage to help pay for their healthcare related expenses. If you or anyone in your family does not currently have qualifying health insurance coverage through an employer, private plan provider, or government program like Medicare and Medicaid, avoid penalties by signing up or exploring the exemptions.

What Are the Exemptions for the California Health Insurance Mandate?

Do you worry about how to find private health insurance to stay compliant with the law? Perhaps you want to sign up for one of the public programs that help seniors or low-income people get the coverage they need. In some rare cases, you may not want to get health insurance at all or have a specific type of hardship or circumstance that makes it excessively difficult to do so.

The Affordable Care Act and the California Health Insurance Mandate have accepted exemptions that help you avoid fines in unique situations.

1 – Tax Filing Exemption Due to Low Income

As in most states around the country, California has a minimum income threshold for filing taxes. Any adult under the age of 65 is required to file federally if they make more than $10,400. Joint married filers have a minimal income of $20,800. Other criteria and thresholds exist, which need to be investigated for the specific instance. If your income falls below these levels, and you do not have to file taxes for the year, you are not mandated to have CA health insurance either.

2 – Affordability Hardship Based on Income

Besides the exemption associated with not making enough to file taxes, there are other affordability hardship options to explore. While many low-income individuals and families get help through government programs like Medicaid, others do not qualify for this assistance. If the lowest cost available healthcare insurance plan costs more than 8.24 % of taxable income, it is considered an unaffordable cost. This pertains to both private plans and those sponsored by an employer.

3 – Short-term Lack of Coverage

People who are in between jobs or otherwise left without health insurance for a period of time less than three months do not realize any penalties or tax fines under the California laws.

4 – Religious Exemptions

Some religious groups and belief systems have legal conscientious objections to modern healthcare that exempts them from the requirement put forth in the California insurance mandate. Also, individuals and families and rolled in a healthcare sharing ministry, in which members share medical expenses for treatments accepted by their belief system, are likewise exempt.

5 – Current Incarceration

Anyone currently in the jail or prison system who has received their final charges and sentence is not bound by the ACA requirements. In these instances, healthcare is handled by the prison system itself.

6 – Undocumented or Illegal Status

The rules surrounding undocumented immigrants and temporary non-citizens residing in the state of California are more complex. However, the health insurance mandate does offer exemptions for people in these situations.

7 – Native American or Indigenous Tribal Membership

Members of tribes recognized by the US federal government are not required to carry standard health insurance. This also includes Alaskan indigenous populations. However, each person who claims his exemption must be eligible for care through the Indian Health Service or tribe-specific healthcare providers.

8 – Non-residence or CA Residents Living Elsewhere

California residents who live in another state or country during the year are not required to maintain state-approved health insurance. Likewise, people temporarily living in the state but who are legal residents of another also get an exemption from the California health insurance mandate.

The goal of the California Health Insurance Mandate is to help every resident of the state afford medical services as needed. Different programs, plan levels, and subsidies are available. However, the exemptions outlined above may help avoid penalties that would make doctor's visits, hospitalization, and prescription medication less affordable overall.

Leave a Reply

Your email address will not be published. Required fields are marked *

Leave a Reply

Your email address will not be published. Required fields are marked *

crossmenu linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram