Will you get a subsidy to help pay for health insurance?


Starting in 2014, the fine for not having health insurance will be either $95 or no more than 1 percent of a person’s income — whichever is greater. A child is considered 18 years of age or younger. In 2015, the fine will be either $325 or 2 percent of income. In 2016, the fine will be $695 or 2.5 percent of income. After 2016, the fine will be based on the cost-of-living adjustment every year.

Read more about the tax penalty and the health care reform law from healthcare.gov.

This Health Care Reform Calculator estimates premiums under the Affordable Care Act and subsequent regulations (“ACA”). Beginning in 2014, tax credits will be available for individuals under age 65 who purchase coverage on their own through an Exchange and are not covered through their employer, Medicare or Medicaid. The tool allows the user to examine the impact at different income levels, ages, family sizes, and regional costs.

Premium calculation estimates were prepared by the Congressional Budget Office.

The calculator does not apply to individuals with ACA-compliant coverage available through an employer.

How to find my Modified Adjusted Gross Income

Start with Adjusted Gross Income (AGI) as defined as gross income minus adjustments to income. We suggest you refer to your 2012 federal income tax return to get a quick estimate of your 2012 AGI. On your 2012 return, please refer to:

Line 4 if you filed a Form 1040EZ
Line 21 if you filed a Form 1040A
Line 37 if you filed a Form 1040
Your AGI needs to be modified if you have the following (we suggest you consult a tax professional):

Any passive loss or passive income, or
Any rental losses (whether or not allowed by IRC § 469(c)(7)), or
IRA, taxable social security or
One-half of self-employment tax (IRC § 469(i)(3)(E)) or
Exclusion under 137 for adoption expenses or
Student loan interest.
Exclusion for income from US savings bonds (to pay higher education tuition and fees)
Qualified tuition expenses (tax years 2002 and later)
Tuition and fees deduction
Any overall loss from a PTP (publicly traded partnership)
Read a summary of the Affordable Care Act penalty provision and the Internal Revenue Service, prepared by the Congressional Research Service.

*“Alternative health insurance solutions” refers to hospital and surgical indemnity insurance and guaranteed issue fixed indemnity insurance plans. “Affordable temporary health insurance“ refers to short-term temporary health insurance plans. These plans are not considered individual major medical health insurance as defined by the Affordable Care Act, and they do not provide all the same benefits or as high a level of coverage as such medical health insurance. You will not get a tax credit for purchasing these plans.

If you are not eligible for a tax credit you may be eligible for Medicaid.

The premium and subsidy amounts displayed are estimates only and the actual amounts of subsidy eligibility may differ. This subsidy calculator is provided for informational purposes only and does not constitute legal or tax advice.