New Rules Under the Health Law

Starting in January 2014, almost everyone is required to have health insurance or pay a penalty.

Have questions?

Individuals can call 1-800-318-2596 (TTY: 1-855-889-4325) to speak to someone who can help. Small businesses can call 1-800-706-7893 (TTY: 1-800-706-7915).

Or, you can click here to find someone close to you who can help in person.

What if I already have insurance? Are there any changes?

If you already have health insurance, there may be some changes to your health plan. You should contact your insurance company to see how the law affects your coverage. If you get your insurance through your job, contact your human resource department at work.

What if I don’t have insurance?

For people without health insurance, the Missouri Health Insurance Marketplace is a website where you can compare and buy health plans. You can get information here, through the Missouri Marketplace, by phone, or in person. Individuals can call 1-800-318-2596 (TTY: 1-855-889-4325). Small businesses should call 1-800-706-7893 (TTY: 1-800-706-7915). Or get help in person at a location near you.

How can I tell if I have insurance?

If you are currently insured or receive health care through one or a combination of the following, you meet the requirement to have health insurance:
  • A health insurance plan offered through your job. This also includes COBRA and retiree coverage.
  • Insurance bought on your own.
  • Medicare.
  • Missouri’s Medicaid program or Children’s Health Insurance Program (CHIP). Both of these programs are called MO HealthNet.
  • TRICARE. This is insurance for active duty service members, retirees, and their families.
  • Veterans Affairs (VA) health care.

Do I have to have health insurance?

If you don’t have insurance in 2014, you may pay a penalty. You don’t have to pay a penalty if:
  • You’re part of a federally recognized religion that prevents you from accepting insurance benefits, such as Amish.
  • You’re a member of a recognized health care sharing ministry.
  • You’re a member of a recognized American Indian tribe.
  • You’re an undocumented immigrant.
  • You’re in jail or prison.
  • You’re not required to file federal income tax because your income is below the filing level. For 2012 individuals under age 65 didn’t have to file taxes if they earned less than $9,750. For a married couple under age 65 filing taxes together, this was income below $19,500.
  • You don’t have an affordable health insurance option available. This means:
    • Health insurance would cost more than 8% of your income.
    • You would have qualified for Medicaid if Missouri had chosen to increase eligibility. The expansion would have covered individuals with income below $15,860 and a family of four with income below $32,500.

I heard there are penalties if you don’t have insurance. Is this true?

If you don’t have health insurance in 2014, you will have to pay a penalty. There are some exceptions to the requirement to have insurance.

The Internal Revenue Service (IRS) will collect the penalty. Starting in 2015 you’ll be asked to show proof of health insurance when you file your federal income taxes. If you do have to pay a penalty, the amount will be taken out of any tax refund you are owed.

The IRS isn’t allowed to use liens or levies to collect any penalties you owe for not having health insurance.

What‘s the penalty for not having health insurance?

If you don’t have health insurance in 2014, you’ll pay the penalty when you file your federal income taxes in 2015. The penalty will be the larger amount of either a flat rate or a percentage of income. The exact amount will depend on family size. The penalty is being phased in between 2014 and 2016. See the chart below.

Year201420152016 and Beyond
Penalty is the larger amount of: 1% of income2% of income2.5% of income
$95 per adult$325 per adult$695 per adult
$47.50 per child$162.50 per child$347.50 per child
(Up to $285 for a family)(Up to $975 for a family)(Up to $2,085 for a family)

What if I can’t afford health insurance?

You may be able to get financial help if you can’t afford to buy health insurance. Small businesses may also be able to get help buying health insurance for employees.

Financial Help for Individuals and Families

Depending on how much money you make, you may be eligible for:
If you can’t afford health insurance, you may qualify for Medicaid. Medicaid is a public health insurance program for people with very low income.

If you have a hard time paying for health insurance and have kids, they may qualify for the Children’s Health Insurance Program (CHIP). CHIP is a public health insurance program for kids with family income above Medicaid limits.

Some people may not be able to afford health insurance but find they don’t qualify for Medicaid or financial help through the Missouri Marketplace. If this applies to you or your family, you may not be required to buy health insurance.

To learn more about financial help, click here.

Financial Help for Small Businesses

If you are a small business owner with 25 or fewer full-time employees, you may be able to get a small business tax credit. You can see if you qualify for this tax credit when you buy insurance for your workers through the SHOP Marketplace. The tax credit is available now.

To learn more about financial assistance for small businesses, click here.