Health Care Insurance Reform Basics

Health Care Reform Basics


Understanding How Mandatory Health Insurance Affects You

A mandate is an official command or a go-ahead. Under the Affordable Care Act, health insurance is mandatory for everyone. Part of the law says that if you don’t have a health plan that provides minimum essential coverage, you may have to pay a penalty, or fee.

Mandatory health insurance is in effect for all Wisconsin residents.

What is the fee for not having mandatory health insurance?

In 2016, the fee ​is 2.5% of income or $695 per person ($347.50 per child under 18). In following years, the fine will remain at 2.5% with an adjustment for inflation. Learn more.


If you don’t have health insurance for less than three months, you don’t have to pay the penalty. However, if you’re uninsured for longer than three months, the annual fee is divided by 12 (the months in the year). You will have to pay this every month that you don’t have health care insurance. You pay the fee when you file your federal income tax return.


It's important to remember that even if you pay the penalty, you still don't have any health insurance coverage. You are responsible for 100% of the cost of your health care. You may think you don't need health insurance because you never get sick. But what if something tragic happens? The amount for your health care services can add up to thousands of dollars that you may not be able to pay.


If paying for mandatory health insurance is a problem, there are many ways to get help paying for health care. Learn more about help with health care and insurance costs.




*Some people may be exempt from this fee. Learn more.