When did the US pass federal individual mandate laws?

Asked by: Carolina Yost  |  Last update: September 10, 2025
Score: 4.8/5 (66 votes)

In the United States, the Affordable Care Act (ACA) signed in 2010 by President Barack Obama imposed a health insurance mandate which took effect in 2014. Under this law, insurance companies are restricted in their ability to alter insurance rates based on the current health of the individual buying the insurance.

When did health insurance become mandatory in the US?

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. This historic reform required that all individuals have health insurance by 2014.

Is there still a federal penalty for not having health insurance?

Exemptions from the requirement to have health insurance

The fee for not having health insurance (sometimes called the "Shared Responsibility Payment" or "mandate”) ended in 2018. This means you no longer pay a tax penalty for not having health coverage.

Are you forced to have health insurance in the US?

This requirement was known as the individual mandate. But in 2017, Congress passed the Tax Cuts and Jobs Act. While having health insurance was still required, the penalty was reduced to zero dollars. This took effect in 2019.

When did America privatize healthcare?

Under the Reagan Administration (1981-1989), regulations loosened across the board, and privatization of healthcare became increasingly common.

Court rules ACA's individual mandate is unlawful

24 related questions found

Which president privatized healthcare?

In February 1971, President Richard Nixon proposed more limited health insurance reform—an employer mandate to offer private health insurance if employees volunteered to pay 25 percent of premiums, federalization of Medicaid for the poor with dependent minor children, merger of Medicare Parts A and B with elimination ...

How did health insurance in the US become employer-based without government mandates?

THE ECONOMY

During World War II, The War Labor Board ruled in 1943 that certain work benefits, including health insurance coverage, should be excluded from the period's wage and price controls. Using generous health benefits then to draw workers, employers began to bolster group health insurance plans.

Are US citizens required by law to have health insurance?

Key Takeaways

Health insurance coverage is no longer mandatory at the federal level, as of Jan. 1, 2019. Some states still require you to have health insurance coverage to avoid a tax penalty.

In what states is it illegal to not have health insurance?

Presently there are six states with individual mandates:
  • California.
  • D.C.
  • Massachusetts.
  • New Jersey.
  • Rhode Island.
  • Vermont (but there's currently no financial penalty attached to the mandate)

Are you allowed to not use your health insurance?

You may choose not to use insurance if the service you need isn't covered, or it's less expensive if you pay out of pocket. In most cases, providers and facilities must give you an estimate when you schedule care at least 3 business days in advance, or if you ask for one.

Can I get Obamacare if I have no income?

There is no income limit. To be eligible to enroll in health coverage through the Marketplace, you: Must live in the United States. Must be a U.S. citizen or national (or be lawfully present).

Can you be denied medical treatment without insurance?

Because of EMTALA, you can't be denied a medical screening exam or treatment for an emergency medical condition based on: If you have health insurance or not. If you can pay for treatment.

When did health insurance mandate end?

Congress eliminated the federal tax penalty for not having health insurance, effective January 1, 2019. While there is no longer a federal tax penalty for being uninsured, some states (CA, MA, NJ, and RI) and DC have enacted individual mandates and may apply a state tax penalty if you lack health coverage for the year.

What is the Kerr Mills Act?

This medical vendor payment program was followed in 1960 by the enactment of the Kerr-Mills legis lation authorizing Medical Assistance to the Aged (MAA), which provided Federal funding to States to cover medical costs for the indigent elderly (Public Law 86-778).

What has led to the decline of United States citizens who don t have health insurance?

Gains in Medicaid and Marketplace coverage contributed to significant declines in the uninsured rate through 2022.

What is cobra insurance?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, ...

What two states do not require insurance?

New Hampshire and Virginia are the only states that do not require auto insurance. However, if you choose not to purchase car insurance in these states, you would still be held liable for any property damage or bodily injury caused by their vehicle.

Does the IRS still require proof of health insurance?

Health care coverage documents

You are not required to send the IRS information forms or other proof of health care coverage when filing your tax return. However, it's a good idea to keep these records on hand. This documentation includes: Form 1095 information forms.

What is the IRS penalty for no health insurance?

The Tax Cut and Jobs Act (TCJA) repealed the penalty (made the penalty amount $0) starting with tax year 2019. But you may wonder, “Do I need health insurance to file taxes after the ACA penalty was repealed?” The answer is no. You no longer will be penalized for not having health insurance.

Can you live in USA without health insurance?

The federal government has since repealed the health coverage requirement and penalty known as the individual mandate. But, some states still require their residents to have health insurance. Having a qualified health plan to avoid fines is essential in these locations.

What is the best healthcare insurance?

Investopedia's analysis ranks Kaiser Permanente as the best health insurance company for 2025 because of its blend of affordability and low customer complaints. UnitedHealthcare and Aetna also earned top marks. We evaluated nine insurers using dozens of criteria, such as customer satisfaction, plan types, and costs.

When did private health insurance start in the US?

During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations in the 1930s. The first employer-sponsored hospitalization plan was created by teachers in Dallas, Texas in 1929.

Can you use Obamacare instead of employer insurance?

Answer: Legally speaking, you certainly can decide to purchase insurance through the online Healthcare Marketplace or health insurance exchange rather than choosing your employer's plan. Obamacare is available to everyone, whether or not their employers offer insurance.

What did people do before health insurance?

The first health insurance

Prior to the 1920s, most surgeries were performed in people's own homes, so hospital bills were rare. People were more concerned about the wages they'd miss out on if they were sick and unable to work.