Insurance coverage

Massachusetts, Vermont and Rhode Island require health insurance coverage

Only a few US states require all residents who can afford it to have health insurance, and three of those are in New England.

Adopted in 2010, the Affordable Care Actalso known as Obamacare, mandated health insurance for nearly all Americans, but Congress later repealed the individual term penalty in 2017, meaning individuals would no longer be financially punished at the federal level for not having health insurance.

Today, an estimated 26 million people in the United States are currently without health insurance coverage.

In 2022, only five states and the District of Columbia require state-level health insurance coverage through local versions of individual mandates. In New England, Massachusetts, Vermont, and Rhode Island, all eligible residents are required to have health insurance, which means that if someone cannot afford health insurance or has experienced a particular difficulty, he will not be penalised. New Jersey and California also require all residents to be enrolled in a health insurance plan.

Only five states and the District of Columbia require eligible residents to have health insurance through individual state-level mandates.

The United States is in the middle of its annual registration period openwhen people can enroll in a health insurance plan for the following calendar year. People are encouraged to sign up by December 15 for coverage that begins January 1. The registration period ends on January 15, 2023 in most states.

This year’s open enrollment is especially critical, as up to 15 million Americans could lose Medicaid coverage when the federal COVID-19 public health emergency ends, according to the Department of Health and Human Services. social – in some cases for reasons as simple as not having updated an address or contact details.

Once the emergency is over, states will begin to reassess who is eligible for coverage, something they have been prohibited from doing since 2020 to ensure uninterrupted Medicaid coverage for low-income people.

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The Biden administration has said it will give states 60 days notice to prepare. The public health emergency must be renewed every 90 days to remain in effect, and for now it is scheduled to end on January 11, 2023. The Centers for Medicaid and Medicare Services is asking states to develop plans on how which they will manage the outcome of the emergency.

Between February 2020 and July 2022, Enrollments for Medicaid and Children’s Health Insurance Program increased nationally by more than 26%.

New Hampshire Health and Human Services has launched a massive awareness campaign to reach nearly 90,800 Medicaid recipients who will lose coverage if they do not confirm their eligibility with the state before the end of the emergency. federal public health.

Does Massachusetts require health insurance coverage?

Massachusetts health care reform law requires most residents over 18 who can afford health insurance to be covered for the whole year or pay a penalty on their tax returns, depending on the state.

Tax penalties can reach $1,908 per year for an individual or $159 per month.

Penalties add up for each month someone fails to comply, but people won’t be penalized for a break in coverage that lasts less than three months. People whose income is less than or equal to 150% of the federal poverty level are not penalized.

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Massachusetts residents must be enrolled in a plan that meets minimum creditable coverage requirements – the minimum level of benefits to be considered properly insured and avoid state financial penalties. The state says most plans meet MCC standards, and insurance companies must affix an MCC compliance notice to their plans to indicate whether they meet the requirements.

Residents can appeal penalties if they have suffered state-recognized hardship such as eviction, utility cuts, death, or bankruptcy.

Does Rhode Island need health insurance coverage?

Rhode Island health insurance mandate came into effect on January 1, 2020, requiring all residents, except those exempted by law, to have eligible health coverage – through an employer, purchased directly from a health insurance company, Medicare and Medicaid, or a health plan purchased through HealthSource RI, the state health exchange.

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Rhode Island imposes personal income tax penalties for those who do not enroll in health insurance. The state calculates the penalties using a “shared responsibility” worksheet. The fee is calculated either as 2.5% of one person’s annual household income or per person ($695 per adult and additional $347.50 per child under 18), whichever is greater.

Like Massachusetts, Rhode Island offers hardship exemptionsthat people can apply for.

Does Vermont need health insurance?

Vermont’s individual health insurance mandate went into effect January 1, 2020, requiring most residents 18 and older to acquire acceptable health insurance coverage and report it on their tax return.

But unlike Massachusetts and Rhode Island, it’s an individual mandate with no teeth. Vermont does not issue financial penalties for non-compliance. In place, state messages to the public that “it’s important that everyone in Vermont is covered,” telling residents that health insurance reduces the risk of costly medical bills; helps cover medications, provider visits and hospital care; and helps people stay healthy by paying for annual exams, screenings and vaccinations.

Vermont law requires individuals to report on their state tax return whether they had health coverage for each month of the year.

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What is the open registration period? How to get health insurance?

The national open registration period began on November 1 and ends on January 15, 2023. For more information, visit or your state’s health insurance marketplace website.

∎ Rhode Island – HealthSourceRI

Massachusetts Health Connector

Vermont Health Connection

New Hampshire Federal Government Facilitated Health Insurance Marketplace

∎ Maine –

∎ Connecticut- CT Health Access