What Happens If I Don't Sign up for Health Insurance?

The Affordable Care Act (ACA) requires you to have health insurance. The ACA is set up to make it easier for people who can't afford health insurance to get it. It is an attempt to make health care more affordable for everyone by reducing the number of people that can't pay their medical bills. When medical bills cannot be paid, doctors and hospital staff cannot be paid, supplies cannot be purchased and services dwindle. This causes prices to rise to cover medical supplies and services. 

The ACA set up penalties for not having health insurance to try to keep people from not being able to pay their medical bills. This portion of the ACA was repealed in 2019, with the authority to enforce health care transferred to the states. 

Enrolling in a health care plan is the right thing to do. It can keep costs down for everyone, and ensure you are taken care of when you need it. If you are under the age of 26, you can stay on your parent's insurance plan until you can afford your own, or you can enroll during the enrollment period.

What Happens If I Don't Have Health Insurance?

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When the ACA went into effect, if you chose not to have health insurance, you faced a fine. This fine was called the Shared Responsibility Payment.

As of 2019, the fine is no longer enforced by the federal government. However, depending on the state you live in, you may be required to pay a fee when you file your state taxes if you do not have health insurance. Be sure to check your state health care regulations to be sure.

If you are fined, it could be a significant amount, so if you decide to take the chance of not having health insurance, you should be ready to pay this amount and factor it into your budget.​ 

Keep in mind that there are financial risks associated with forgoing health insurance, such as not being able to pay for any health care. This can turn into large amounts of debt should you need more than minor care. This is why you should consider health insurance a necessity instead of a luxury. 

Reasons to Get Health Insurance

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While you may not want to spend the money on health insurance, there are a wide variety of reasons that you need to get health insurance.

It can be very expensive to deal with an unexpected medical emergency like appendicitis or a broken leg from recreational activities. According to HealthCare.gov, casting a broken leg can cost up to $7500. If you need to stay in the hospital for 3 days, expect close to $30,000 just for staying there.

Medical debt can bankrupt you. If you are out skiing or biking and fall and break both legs, you'll be in the hospital for a few days. $15,000 for the broken legs and $30,000 for the 3-day stay will suddenly put you in $45,000 of debt. Many hospitals will work with you to set up a payment plan, but the minimum payments may still be more than you can afford and it may take you decades to pay off the debt. 

Health insurance makes it easier to get preventive care so that you do not need more expensive procedures later. Taking care of small things like ear or sinus infections can prevent you from developing more serious complications.

Many plans help cover the cost of annual physicals. Annual physicals can identify unknown medical problems, possibly preventing you from collecting unexpected medical bills.​ 

Are There Affordable Options?

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There are a variety of ways that you can obtain affordable health insurance. You may consider a high-deductible health plan (HDHP), which offers lower monthly premiums but uses higher deductibles.  If you do choose this option, you could set up a Health Savings Account (HSA). An HSA is an account that you save money in, that lets you cover medical payments with tax-free earnings. 

You may be able to get coverage under your parents' health insurance, as long as you are under the age of 26. You should also explore health insurance offered by your employer, or even independent health insurance.

However, the most affordable option may be through your state's health insurance exchanges. These exchanges are websites set up to assist you in finding health insurance plans that are right for you.

When choosing a health insurance plan, you should carefully choose the best policy that is currently available to you. Take the time to review your options and choose a policy that will work for you, your budget and your health needs.  

What Is the Time Frame to Enroll?

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Health insurance open enrollment for the next coverage year begins Nov. 1 and runs through Dec. 15, 2019. If you enroll during this time, you will be covered for that year. This date changes every year, so be sure to check back towards the end of the year and make sure you are covered.

If you truly cannot afford health coverage, you may want to see if you qualify for Medicaid. You no longer need to file for an exemption if you cannot afford healthcare. Check with your state legislature for filing for a health care exemption.

If you miss the deadline to enroll, you may face state fines if your state imposes them, so be sure to stay on top of your enrollment.

You are able to enroll at Healthcare.gov. If your state is listed on HealthCare.gov, you'll need to click on your state's link and enroll on their website.

You can also enroll in independent health insurance throughout the year. An insurance agent can help you determine if the plan meets the basic qualifications.

Updated by Rachel Morgan Cautero