Personal Health care mandate

Overview

Beginning January 1, 2020, California residents must either:

  • Have qualifying health insurance coverage
  • Obtain an exemption from the requirement to have coverage
  • Pay a penalty when they file their state tax return

You report your health care coverage for 2023 on your 2023 tax return, which you will file in the spring of 2024. If you, your spouse or domestic partner, and dependents had qualifying health care coverage for each month of 2023, then make sure you check the “Full-year health care coverage box,” line 92, on your return.

Health care forms

For more information on Health Care Mandate forms, check out this video: Health Care Mandate Video - Forms for Tax Season

Make sure you have health care coverage

To avoid a penalty, you need minimum essential coverage (MEC) for each month of the year for:

  • Yourself
  • Your spouse or domestic partner
  • Your dependents

Many people already have qualifying health insurance coverage through:

  • Employer-sponsored plans
  • Coverage purchased through Covered California or directly from insurers
  • Medicare (Part A and C)
  • Most Medicaid plans

Visit the California Department of Managed Healthcare to view the types of health coverage that qualify as MEC.

Contact your plan provider to verify if their specific plan meets the MEC requirements.

Get coverage

If you do not have coverage, open enrollment continues through January 31, 2024. Visit Apply | Covered California™ or call 800-300-1506 to sign up for health care coverage.

Special enrollment period

Individuals may enroll in health care coverage during Covered California’s special enrollment period, generally from November through January. Eligibility requirements are similar to those in place during the annual open-enrollment period. Visit Covered California or call 800-300-1506 to get more information.

Exemptions

You may qualify for an exemption to avoid the penalty. Most exemptions may be claimed on your state income tax return.

Exemptions processed by FTB and Covered California
Exemptions Claimed on State Tax Return Exemptions Processed by Covered California
  • Income is below the tax filing threshold
  • Health coverage is considered unaffordable (exceeded 8.17% of household income for the 2023 taxable year)
  • Families’ self-only coverage combined cost is unaffordable
  • Short coverage gap of three consecutive months or less
  • Certain non-citizens who are not lawfully present
  • Certain citizens living abroad/residents of another state or U.S. territory
  • Members of health care sharing ministry
  • Members of federally-recognized Indian tribes including Alaskan Natives
  • Incarceration (other than incarceration pending the disposition of charges)
  • Member if applicable household born or adopted during the year
  • Member of applicable household died during the year
  • Enrolled in limited or restricted-scope Medi-Cal or other coverage from the California Department of Health Care Services
  • Religious conscience exemption
  • Affordability hardship
  • General hardships

Visit Covered California for more details.

Apply now for exemptions granted by Covered California.

Financial help

Help meeting the requirements for health care coverage is available for qualifying individuals and families through Covered California and is based on:

  • Household size
  • Age
  • Income
  • Region

Options for no-and low-cost coverage are also available through the Medi-Cal program.

To find out more about health insurance options and financial help, visit Covered California.

Penalty

You will have to pay a penalty, the Individual Shared Responsibility Penalty, when you file your state tax return if:

  • You did not have health coverage
  • You were not eligible for an exemption from coverage for any month of the year

The penalty for no coverage is based on:

  • The number of people in your household
  • Your California state income

Use our Penalty Estimator tool to estimate the penalty you may owe.

Sample penalty amounts for 2023
Household size If you make less than You may pay
Individual $49,763 $900
Married Couple $92,100 $1,800
Family of 4 (2 adults, 2 children) $142,000 $2,700

The penalty for a dependent child is half of what it would be for an adult, $450, for 2023.

How to estimate

The penalty will be the higher of either:

  • A flat amount, based on the number of people in the tax household, or
  • A percentage of the household income

Flat amount

Pay $900 per adult and $450 per child.

Percentage of household income

Pay 2.5% of the amount of gross income that exceeds the filing threshold requirements based on the tax filing status and number of dependents.

Example:

A family of 3 with a gross household income of $150,000 that includes:
  • 2 parents
  • 1 child

Flat amount calculation
$900 per adult, $450 per child: ($900 x 2) + $450 = $2,250

Percentage of household income calculation
2.5% of gross income that exceeds filing threshold: ($150,000 - $57,994 [1]) x .025) = $2,300.15.

Penalty amount
Since the percentage of household income was higher than the flat amount, the penalty amount for this family is $2,300.15

[1] $57,994 is the state filing threshold for a married couple, both under 65 years old with one dependent for the 2023 tax year.