Health insurance penalty by state: where you still pay for not having coverage in 2026 and 2027

Where the penalty applies

The federal Obamacare penalty dropped to $0 starting in 2019. Since then, some states created their own requirement to have health insurance, with a penalty for those who don’t:

• California
• Massachusetts
• New Jersey
• Rhode Island
• Washington, D.C.

Vermont also requires you to report coverage on your tax return, but it doesn’t charge a penalty. In every other state, including Florida, Texas and New York, there is no state penalty.

California

It applies to residents, their spouse or registered domestic partner, and their dependents. The penalty is figured on Form FTB 3853 of the state return.

• Tax year 2025 (the latest figure published by the FTB): $950 per adult and $475 per child, with a household maximum of $2,850 for that part.
• Or 2.5% of household income above the filing threshold, if that’s higher. You pay the larger amount.
• There’s a cap: the average cost of a bronze plan. For 2026 it’s $420 a month per person, and for 2027, $469.

The per-adult and per-child amounts are adjusted every year. The FTB hasn’t published the 2026 amounts yet.

Massachusetts

In Massachusetts the penalty applies only to adults 18 and older who had access to affordable coverage; there is no penalty for children. It’s reported on Schedule HC of the state return. If your income is 150% of the federal poverty level or less, you don’t pay a penalty.

Penalty per person for tax year 2026, by income:

• 150% to 200% of the poverty level: $312 a year.
• 200% to 250%: $612 a year.
• 250% to 300%: $912 a year.
• 300% to 400%: $1,404 a year.
• Over 400%: $2,532 a year.

A married couple pays each spouse’s penalty. Massachusetts also requires coverage to meet its own standard (“Minimum Creditable Coverage”), which is stricter than in other states.

New Jersey

It applies to the whole household. The penalty is paid with the NJ-1040, and exemptions are reported on Schedule NJ-HCC. If you’re not required to file a tax return, you’re exempt.

• Tax year 2025: $695 per adult and $347.50 per child, with a maximum of $2,085 for that part.
• Or 2.5% of income above the filing threshold ($10,000 single; $20,000 married), if that’s higher.
• According to the state, in 2025 the penalty for one person ranged from $695 to $4,908.

New Jersey hasn’t published its 2026 figures yet.

Rhode Island

It applies to all residents and their dependents. It’s paid with the RI-1040 and Form IND-HEALTH.

• Tax year 2025: $695 per adult and $347.50 per child, with a maximum of $2,085 for that part.
• Or 2.5% of income above the federal standard deduction, if that’s higher.
• Capped at $357 a month per person (the average cost of a bronze plan in 2025).

Rhode Island hasn’t published its 2026 figures yet.

Washington, D.C.

It applies to residents, their spouse or registered domestic partner, and their dependents. It’s paid with the D-40 and Schedule HSR.

• Tax year 2026: $845 per adult and $422.50 per child, with a family maximum of $2,535 for that part.
• Or 2.5% of income above the federal filing threshold, if that’s higher.
• Capped at $4,965 a year per person.

What coverage protects you from the penalty (and what doesn’t)

To avoid the penalty you need coverage that counts as minimum essential coverage for the whole year. It includes, among others:

• A plan from your state’s Marketplace: Covered California, the Massachusetts Health Connector, Get Covered New Jersey, HealthSource RI or DC Health Link.
• Your job’s health plan or your spouse’s.
• Medicaid (Medi-Cal in California), Medicare or CHIP.

Fixed indemnity plans (which pay a set amount per hospital day) and dental-only or vision-only plans don’t count. Limited-benefit plans generally don’t either (Washington, D.C. says so expressly). Before buying a private plan in these states, get written confirmation that it counts toward avoiding the penalty.

Who doesn’t pay the penalty

Each state has its own exemptions. The most common are:

• Income below the tax filing threshold.
• A short gap in coverage: about 3 consecutive months or less, depending on the state.
• The cheapest available coverage isn’t affordable for your income.
• Serious financial hardship, such as homelessness or an eviction. You request it from your state’s Marketplace.
• Other cases, such as membership in a recognized tribe, incarceration or living outside the country.

Dates to enroll for 2027

Each of these places has its own Marketplace and its own dates:

• California (Covered California): November 1, 2026 to January 31, 2027. For coverage starting January 1, enroll by December 31.
• Massachusetts (Health Connector): October 23, 2026 to January 23, 2027. For coverage starting January 1, enroll by December 23.
• New Jersey (Get Covered NJ): November 1, 2026 to January 31, 2027. For coverage starting January 1, enroll by December 31.
• Rhode Island (HealthSource RI): November 1, 2026 to January 31, 2027.
• Washington, D.C. (DC Health Link): November 1, 2026 to January 31, 2027. For coverage starting January 1, pick your plan by December 15.

Outside these dates you can only enroll if you have a qualifying life event for a special enrollment period, such as getting married, having a baby, moving or losing your coverage.

Frequently asked questions