Kevin Knauss: Health, History, Travel, Insurance
The penalty is the higher of the flat rate amount or the income percentage. With the income, California takes your income and subtracts the filing threshold dollar amount. They then multiply the remainder by 2.5 percent. If the percentage amount is greater than the flat amount, that is the amount that is added to the income tax return as a penalty.
The minimum annual income in order to become eligible for the Covered California health insurance subsidies for a single adult is $18,756 for 2022. That is $980 higher than the minimum annual income for 2021, approximately a 6 percent increase. The minimum amount for 2 adults is $25,269 annual income. Estimated income amounts below 138 percent of the federal poverty level on the Covered California application will make the household eligible for Medi-Cal.
As of November 2020, the only way to apply for an exemption through Covered California was to use an online application that utilizes DocuSign. For individuals who do not own a computer or do not have internet access, this could be challenge. I have not found any paper exemption applications on the Covered California website. That doesn’t mean they are not there or that they won’t be created later.
This disparity between penalty and the cost of health insurance is driving people to enroll in indemnity plan, discount health care plans, and the health care sharing programs. None of these programs are a substitute for real health insurance. But if a family can save $20,000, even after paying the penalty for not having coverage, that sort of cash goes a long way to meeting basic living expenses in California, plus a few trips to urgent care. And if the family is not subject to the penalty because the coverage is considered unaffordable, the individual mandate penalty is moot.
Under California legislation SB 78, employees of small groups who had previously waived coverage will have a Special Enrollment Period to sign up for health insurance through their employer for 2020.
Covered California has partnered with the Franchise Tax Board to produce a 2020 Individual Mandate Penalty Fact Sheet that includes how to calculate a potential penalty.
California’s individual mandate penalty will require residents to prove they either had minimum essential coverage during the year, have a valid exemption, or pay a penalty. The penalty will be the greater of $695 per adult ($347 per child) OR 2.5% of the household income. The verification of creditable minimum essential coverage and/or the ultimate penalty will be reconciled when residents file their state income tax returns with the Franchise Tax Board.
