26 U.S.C. § 5000A
(b) Shared responsibility payment
(3) Payment of penalty If an individual with respect to whom a penalty is imposed by this section for any month—
(c) 1 Amount of penalty
(1) In general The amount of the penalty imposed by this section on any taxpayer for any taxable year with respect to failures described in subsection (b)(1) shall be equal to the lesser of—
(2) Monthly penalty amounts For purposes of paragraph (1)(A), the monthly penalty amount with respect to any taxpayer for any month during which any failure described in subsection (b)(1) occurred is an amount equal to 1⁄12 of the greater of the following amounts:
(A) Flat dollar amount An amount equal to the lesser of—
(B) Percentage of income An amount equal to the following percentage of the excess of the taxpayer’s household income for the taxable year over the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer for the taxable year:
(3) Applicable dollar amount For purposes of paragraph (1)—
(D) Indexing of amount In the case of any calendar year beginning after 2016, the applicable dollar amount shall be equal to $695, increased by an amount equal to—
If the amount of any increase under clause (i) is not a multiple of $50, such increase shall be rounded to the next lowest multiple of $50.
(4) Terms relating to income and families For purposes of this section—
(B) Household income The term “household income” means, with respect to any taxpayer for any taxable year, an amount equal to the sum of—
(ii) the aggregate modified adjusted gross incomes of all other individuals who—
(C) Modified adjusted gross income The term “modified adjusted gross income” means adjusted gross income increased by—
(d) Applicable individual For purposes of this section—
(2) Religious exemptions
(A) Religious conscience exemption Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is—
(B) Health care sharing ministry
(ii) Health care sharing ministry The term “health care sharing ministry” means an organization—
(e) Exemptions No penalty shall be imposed under subsection (a) with respect to—
(1) Individuals who cannot afford coverage
(B) Required contribution For purposes of this paragraph, the term “required contribution” means—
(4) Months during short coverage gaps
(B) Special rules For purposes of applying this paragraph—
The Secretary shall prescribe rules for the collection of the penalty imposed by this section in cases where continuous periods include months in more than 1 taxable year.
(f) Minimum essential coverage For purposes of this section—
(1) In general The term “minimum essential coverage” means any of the following:
(A) Government sponsored programs Coverage under—
(2) Eligible employer-sponsored plan The term “eligible employer-sponsored plan” means, with respect to any employee, a group health plan or group health insurance coverage offered by an employer to the employee which is—
Such term shall include a grandfathered health plan described in paragraph (1)(D) offered in a group market.
(3) Excepted benefits not treated as minimum essential coverage The term “minimum essential coverage” shall not include health insurance coverage which consists of coverage of excepted benefits—
(4) Individuals residing outside United States or residents of territories Any applicable individual shall be treated as having minimum essential coverage for any month—
(g) Administration and procedure
(2) Special rules Notwithstanding any other provision of law—
(B) Limitations on liens and levies The Secretary shall not—
(Added and amended Pub. L. 111–148, title I, § 1501(b), title X, § 10106(b)–(d), , 124 Stat. 244, 909, 910; Pub. L. 111–152, title I, §§ 1002, 1004(a)(1)(C), (2)(B), , 124 Stat. 1032, 1034; Pub. L. 111–159, § 2(a), , 124 Stat. 1123; Pub. L. 111–173, § 1(a), , 124 Stat. 1215; Pub. L. 115–97, title I, §§ 11002(d)(1)(GG), 11081(a), , 131 Stat. 2060, 2092; Pub. L. 115–120, div. C, § 3002(g)(2)(A), , 132 Stat. 35.)
Pub. L. 115–97, title I, § 11081, , 131 Stat. 2092, amended subsection (c) of this section, applicable to months beginning after . After amendment, subsection (c) reads as follows:
(c) Amount of penalty
(1) In general
The amount of the penalty imposed by this section on any taxpayer for any taxable year with respect to failures described in subsection (b)(1) shall be equal to the lesser of—
(A) the sum of the monthly penalty amounts determined under paragraph (2) for months in the taxable year during which 1 or more such failures occurred, or
(B) an amount equal to the national average premium for qualified health plans which have a bronze level of coverage, provide coverage for the applicable family size involved, and are offered through Exchanges for plan years beginning in the calendar year with or within which the taxable year ends.
(2) Monthly penalty amounts
For purposes of paragraph (1)(A), the monthly penalty amount with respect to any taxpayer for any month during which any failure described in subsection (b)(1) occurred is an amount equal to 1⁄12 of the greater of the following amounts:
(A) Flat dollar amount
An amount equal to the lesser of—
(i) the sum of the applicable dollar amounts for all individuals with respect to whom such failure occurred during such month, or
(ii) 300 percent of the applicable dollar amount (determined without regard to paragraph (3)(C)) for the calendar year with or within which the taxable year ends.
(B) Percentage of income
An amount equal to the following percentage of the excess of the taxpayer’s household income for the taxable year over the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer for the taxable year:
(i) 1.0 percent for taxable years beginning in 2014.
(ii) 2.0 percent for taxable years beginning in 2015.
(iii) Zero percent for taxable years beginning after 2015.
(3) Applicable dollar amount
For purposes of paragraph (1)—
(A) In general
Except as provided in subparagraphs (B) and (C), the applicable dollar amount is $0.
(B) Phase in
The applicable dollar amount is $95 for 2014 and $325 for 2015.
(C) Special rule for individuals under age 18
If an applicable individual has not attained the age of 18 as of the beginning of a month, the applicable dollar amount with respect to such individual for the month shall be equal to one-half of the applicable dollar amount for the calendar year in which the month occurs.
See 2017 Amendment notes below.
For inflation adjustment of certain items in this section, see Revenue Procedures listed in a table under section 1 of this title.
The Patient Protection and Affordable Care Act, referred to in subsecs. (d)(2)(A), (e)(1)(A), (2), and (f)(5), is Pub. L. 111–148, , 124 Stat. 119. Title I of the Act enacted chapter 157 of Title 42, The Public Health and Welfare, and enacted, amended, and transferred numerous other sections and notes in the Code. Sections 1311(d)(4)(H) and 1412(b)(1)(B) of the Act are classified to sections 18031(d)(4)(H) and 18082(b)(1)(B), respectively, of Title 42. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of Title 42 and Tables.
The Social Security Act, referred to in subsec. (f)(1)(A)(i) to (iii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Part A of title XVIII of the Act is classified generally to part A (§ 1395c et seq.) of subchapter XVIII of chapter 7 of Title 42, The Public Health and Welfare. Titles XIX and XXI of the Act are classified generally to subchapters XIX (§ 1396 et seq.) and XXI (§ 1397aa et seq.), respectively, of chapter 7 of Title 42. Section 2107(g) of the Act is classified to section 1397gg(g) of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Section 2791 of the Public Health Service Act, referred to in subsec. (f)(2)(A), (3), is classified to section 300gg–91 of Title 42, The Public Health and Welfare.
2018—Subsec. (f)(1)(A)(iii). Pub. L. 115–120 inserted “or under a qualified CHIP look-alike program (as defined in section 2107(g) of the Social Security Act)” before comma at end.
2017—Subsec. (c)(2)(B)(iii). Pub. L. 115–97, § 11081(a)(1), substituted “Zero percent” for “2.5 percent”.
Subsec. (c)(3)(A). Pub. L. 115–97, § 11081(a)(2)(A), substituted “$0” for “$695”.
Subsec. (c)(3)(D). Pub. L. 115–97, § 11081(a)(2)(B), struck out subpar. (D). Text read as follows: “In the case of any calendar year beginning after 2016, the applicable dollar amount shall be equal to $695, increased by an amount equal to—
“(i) $695, multiplied by
“(ii) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year, determined by substituting ‘calendar year 2015’ for ‘calendar year 2016’ in subparagraph (A)(ii) thereof.”
Subsec. (c)(3)(D)(ii). Pub. L. 115–97, § 11002(d)(1)(GG), substituted “for ‘calendar year 2016’ in subparagraph (A)(ii)” for “for ‘calendar year 1992’ in subparagraph (B)”.
2010—Subsec. (b)(1). Pub. L. 111–148, § 10106(b)(1), amended par. (1) generally. Prior to amendment, text read as follows: “If an applicable individual fails to meet the requirement of subsection (a) for 1 or more months during any calendar year beginning after 2013, then, except as provided in subsection (d), there is hereby imposed a penalty with respect to the individual in the amount determined under subsection (c).”
Subsec. (c)(1), (2). Pub. L. 111–148, § 10106(b)(2), amended pars. (1) and (2) generally. Prior to amendment pars. (1) and (2) related to the amount of and dollar limitations on penalty for failure to maintain minimum essential coverage.
Subsec. (c)(2)(B). Pub. L. 111–152, § 1002(a)(1)(A), inserted “the excess of” before “the taxpayer’s household income” and “for the taxable year over the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer” before “for the taxable year” in introductory provisions.
Subsec. (c)(2)(B)(i). Pub. L. 111–152, § 1002(a)(1)(B), substituted “1.0” for “0.5”.
Subsec. (c)(2)(B)(ii). Pub. L. 111–152, § 1002(a)(1)(C), substituted “2.0” for “1.0”.
Subsec. (c)(2)(B)(iii). Pub. L. 111–152, § 1002(a)(1)(D), substituted “2.5” for “2.0”.
Subsec. (c)(3)(A). Pub. L. 111–152, § 1002(a)(2)(A), substituted “$695” for “$750”.
Subsec. (c)(3)(B). Pub. L. 111–152, § 1002(a)(2)(B), substituted “$325” for “$495”.
Pub. L. 111–148, § 10106(b)(3), substituted “$495” for “$350”.
Subsec. (c)(3)(D). Pub. L. 111–152, § 1002(a)(2)(C), substituted “$695” for “$750” in introductory provisions and cl. (i).
Subsec. (c)(4)(B)(i), (ii). Pub. L. 111–152, § 1004(a)(1)(C), substituted “modified adjusted gross” for “modified gross”.
Subsec. (c)(4)(C). Pub. L. 111–152, § 1004(a)(2)(B), amended subpar. (C) generally. Prior to amendment, text read as follows: “The term ‘modified gross income’ means gross income—
“(i) decreased by the amount of any deduction allowable under paragraph (1), (3), (4), or (10) of section 62(a),
“(ii) increased by the amount of interest received or accrued during the taxable year which is exempt from tax imposed by this chapter, and
“(iii) determined without regard to sections 911, 931, and 933.”
Subsec. (c)(4)(D). Pub. L. 111–152, § 1002(b)(1), struck out subpar. (D). Text read as follows:
“(i) In general.—The term ‘poverty line’ has the meaning given that term in section 2110(c)(5) of the Social Security Act (42 U.S.C. 1397jj(c)(5)).
“(ii) Poverty line used.—In the case of any taxable year ending with or within a calendar year, the poverty line used shall be the most recently published poverty line as of the 1st day of such calendar year.”
Subsec. (d)(2)(A). Pub. L. 111–148, § 10106(c), amended subpar. (A) generally. Prior to amendment, text read as follows: “Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.”
Subsec. (e)(1)(C). Pub. L. 111–148, § 10106(d), amended subpar. (C) generally. Prior to amendment, text read as follows: “For purposes of subparagraph (B)(i), if an applicable individual is eligible for minimum essential coverage through an employer by reason of a relationship to an employee, the determination shall be made by reference to the affordability of the coverage to the employee.”
Subsec. (e)(2). Pub. L. 111–152, § 1002(b)(2), substituted “below filing threshold” for “under 100 percent of poverty line” in heading and “the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.” for “100 percent of the poverty line for the size of the family involved (determined in the same manner as under subsection (b)(4)).” in text.
Subsec. (f)(1)(A)(iv). Pub. L. 111–159, § 2(a)(1), added cl. (iv) and struck out former cl. (iv) which read as follows: “the TRICARE for Life program,”.
Subsec. (f)(1)(A)(v). Pub. L. 111–173, § 1(a), amended cl. (v) generally. Prior to amendment, cl. (v) read as follows: “the veteran’s health care program under chapter 17 of title 38, United States Code,”.
Subsec. (f)(1)(A)(vii). Pub. L. 111–159, § 2(a)(2)–(4), added cl. (vii).
Pub. L. 115–120, div. C, § 3002(g)(2)(B), , 132 Stat. 35, provided that:
“The amendment made by subparagraph (A) [amending this section] shall apply with respect to taxable years beginning after
December 31, 2017.”
Amendment by section 11002(d)(1)(GG) of Pub. L. 115–97 applicable to taxable years beginning after , see section 11002(e) of Pub. L. 115–97, set out as a note under section 1 of this title.
Pub. L. 115–97, title I, § 11081(b), , 131 Stat. 2092, provided that:
“The amendments made by this section [amending this section] shall apply to months beginning after
December 31, 2018.”
Pub. L. 111–173, § 1(b), , 124 Stat. 1215, provided that:
“The amendment made by subsection (a) [amending this section] shall take effect as if included in section 1501(b) of the Patient Protection and Affordable Care Act [
Pub. L. 111–148].”
Pub. L. 111–159, § 2(b), , 124 Stat. 1123, provided that:
“The amendments made by this section [amending this section] shall take effect as if included in section 1501(b) of the Patient Protection and Affordable Care Act [
Pub. L. 111–148] and shall be executed immediately after the amendments made by such section 1501(b).”
Pub. L. 111–148, title I, § 1501(d), , 124 Stat. 249, provided that:
“The amendments made by this section [enacting this section and
section 18091 of Title 42, The Public Health and Welfare] shall apply to taxable years ending after
December 31, 2013.”
1 See Amendment of Subsection (c) note below.
2 So in original. Probably should be followed by “the”.
3 So in original. The semicolon probably should be a comma.