Exemptions from the ACA Individual Mandate

Written by Access Health CT | Published November 22nd, 2023 | Updated November 22nd, 2023

Starting January 1, 2014, the individual shared responsibility provision of the Patient Protection and Affordable Care Act (ACA) required individuals to have Minimum Essential Health Coverage (MEC) each month (known as the "Individual Mandate"), or pay a financial penalty for failure to have MEC (known as the "Shared Responsibility Payment"). Individuals, however, could qualify for an exemption from the Individual Mandate and avoid paying the financial penalty for failure to have MEC. There are several types of exemptions, including, for example, exemptions based on membership in certain religious sects and exemptions based on hardship and affordability. 

Under the Tax Cuts and Jobs Act, the Shared Responsibility Payment was reduced to $0, effective for months after December 31, 2018. Therefore, starting with the 2019 tax year, individuals do not need to pay the Shared Responsibility Payment if they do not have MEC or qualify for an exemption from the Individual Mandate. 

Because the Individual Mandate remains in place despite the reduction of the Shared Responsibility Payment to $0, an exemption for hardship or affordability is required for those individuals over the age of 30 looking to purchase a catastrophic health plan.


Claiming a Hardship or Affordability Exemption from the Individual Mandate to Purchase a Catastrophic Health Plan

An exemption for hardship or affordability from the Individual Mandate is required for those individuals over the age of 30 looking to purchase a catastrophic health plan. If you're under 30, you don't need an exemption to enroll in a catastrophic plan. 

An exemption for hardship or affordability to purchase a catastrophic plan can only be granted by Access Health CT. Click here to download the application and the instructions about how to complete the form. 

For tax year 2024, you can claim an Affordability Exemption ONLY if the lowest-cost coverage available to you through Access Health CT or through an employer-sponsored plan would cost you more than 8.39% of your household's Modified Adjusted Gross Income in 2024. 

A hardship exemption may be granted for various reasons, including, for example: 

  • Bankruptcy
  • Eviction
  • Natural Disaster 
  • Religious beliefs
  • Financial Hardship