Last Reviewed: Mon, Oct 18, 2021
Technically, the Affordable Care Act -- aka Obamacare -- still says that you must have health insurance. Practically, however, the federal tax penalty for going without health insurance has been “zeroed out.” That means you’ll still have to report your coverage status on your federal tax return, but you won’t have to pay a penalty if you aren’t covered.
A few states have passed their own health insurance requirements, but as we approach open enrollment for 2022 health plans, Pennsylvania is not one of them.
If you’re interested -- or if the tax penalty comes back -- here’s what the Affordable Care Act still says about the kinds of health insurance Americans should have.
What Qualifies as Minimum Essential Coverage?
The Affordable Care Act requires you to have what’s called “minimum essential coverage” or MEC. The following types of health coverage meet the ACA’s guidelines:
- any health plan bought through Pennie
- individual health plans purchased outside Pennie, if they meet the standards for qualified health plans
- any “grandfathered” individual insurance plan you’ve had since March 23, 2010, or earlier
- any job-based plan, including retiree plans and COBRA coverage
- Medicare Part A or Part C (Part B by itself doesn’t qualify)
- most Medicaid coverage, except for limited coverage plans
- coverage under the Children’s Health Insurance Program (CHIP)
- coverage under a parent’s plan
- most student health plans (check with your school to see if the plan counts as qualifying health coverage)
- health coverage for Peace Corps volunteers
- certain types of veterans health coverage through the Department of Veterans Affairs
most TRICARE plans
- coverage under the Department of Defense Nonappropriated Fund Health Benefits Program
- Refugee Medical Assistance
- state high-risk pools for plan or policy years that started on or before December 31, 2014 (check with your high-risk pool plan to see if it counts as qualifying health coverage)
If you want a more detailed list, see Minimum Essential Coverage on the IRS website.
What Doesn’t Qualify as Minimum Essential Coverage?
Some types of health plans don’t meet the requirements for coverage under Obamacare. These include vision insurance, dental insurance, workers’ compensation, coverage limited to a specific condition, and plans that offer only discounted medical services.
To find out how to get covered, see How to Sign Up for Obamacare in Pennsylvania.
For information about costs, see How Much Does Obamacare Cost in Pennsylvania?
You may also be interested in:
Where to go in Pennsylvania to get health plans under the Affordable Care Act (Obamacare) and how to get help with the application process.
Essential facts about the Affordable Care Act (ACA or Obamacare) in Pennsylvania, including whether you must get health insurance, how much it costs, and how you can save money.
The Affordable Care Act (Obamacare) tax penalty has been set to zero, but some states have enacted their own health insurance requirements.