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University of Illinois Extension

About the ACA

The Patient Protection and Affordable Care Act (ACA) is a law that requires individuals to purchase health insurance coverage. In 2012, the Census Bureau reported that over 48 million Americans do not have insurance. The ACA was passed in order to make sure that everyone had access to insurance and that the insurance covers ten essential health benefits. If insurance coverage is not purchased there is a penalty. The individual penalty increases beginning in 2014 and continues to increase through 2016.

Penalty for Failure to Enroll

Calendar Year Per-Person Penalty Amount Percentage of Income
2014 $95 1%
2015 $325 2%
2016 $695 2.5%

* The penalty formula will be based on whichever amount is higher.

The flat dollar amount is based on the number of uninsured individuals in a household. Each adult counts as 1 and each minor counts as a ½ up to a max of three times.

In 2016:

  • Single person individual penalty = $695
  • Married couple ($695 x 2) = $1390
  • Married couple plus one minor child ($695 x 2.5) = $1737.50
  • Married couple plus two, three, four, or more minor children ($95 x 3) = $2085

The online Health Insurance Marketplace is now open for individuals and small businesses to choose health insurance. Coverage begins January 1, 2016 depending on when one enrolls. The ACA will provide families and small businesses that currently do not have an insurance option to choose health coverage that meets their needs based on their budget.

Did you know?

  • Health reform is intended to improve access to both health insurance and health care.
  • The ACA ensures all Americans will have 10 essential health benefits:
    1. Ambulatory patient services,
    2. Emergency services,
    3. Hospitalization,
    4. Maternity and newborn care,
    5. Mental health and substance abuse services,
    6. Prescription drugs,
    7. Rehabilitative services and devices,
    8. Laboratory services,
    9. Prevention and wellness services, and
    10. Pediatric services, including oral and vision care.
  • The ACA includes a patient’s bill of rights.