Obamacare deadline 101: Do I have to enroll or not?

The Obamacare deadline to enroll in a health insurance plan is Monday, but many people are confused about whether they need to do anything or whether they can get an extension.

Jerry Lara/San Antonio Express-News/AP
People line up to enroll for health insurance at the Alamodome in San Antonio, Texas, on Monday. The deadline is just hours away to sign up for insurance in the first enrollment period under President Obama's signature health care law.

With the deadline clock ticking down, heavy website traffic on the federal HealthCare.gov website suggests that plenty of Americans are trying to enroll – or at least thinking about enrolling – in Obamacare.

How do you know if you need to enroll?

Basically, if you have health insurance already, you’re OK. And if you’re not insured you have three choices:

  1. Enroll now, either on an Obamacare exchange or with private insurer outside the Obamacare marketplace. If you get started with applying for coverage on March 31 via the marketplace, the Obama administration has promised some extra time to complete the process over the next couple of weeks
  2. Qualify for an exemption from the law’s “individual mandate” to have insurance.
  3. Be ready to pay a tax penalty a year from now, when your 2014 taxes are due. The penalty is essentially $95 or 1 percent of your income, whichever is higher.

One followup question is: Does my health insurance meet Obamacare’s standards? The Affordable Care Act, often called Obamacare, says you could owe the tax penalty if you don’t have what’s called “minimum essential coverage.”

The large majority of Americans already have this. Some examples of what qualifies, in addition to what’s offered on the Obamacare marketplace:

  • Health insurance coverage provided by your employer.
  • Coverage from a government-sponsored program for which you are eligible. Examples include Medicare, Medicaid (which can be called by names that vary by state), CHIP, COBRA, and health care programs for military veterans.
  • Other health insurance recognized by the Department of Health & Human Services, which can include a plan bought directly from an insurance company.

Some special allowances apply to people who live outside the 50 states or District of Columbia. The IRS says that US citizens living abroad and “bona fide residents of the United States territories” are treated as having minimum essential coverage.

If you’re not sure about your current status, an IRS question-and-answer sheet includes more detail.

For the uninsured who don’t want to buy insurance or can’t afford it, various exemptions under the law may provide a way out. More information on this is available on the IRS website, following some description of minimum essential coverage.

To enroll on your state’s Obamacare exchange, you can start at HealthCare.gov. You can also meet the requirement for coverage by going to a private insurance agency off the marketplace, such as ehealthinsurance.com. But the Obamacare exchanges may save you money because of subsidies based on income and the size of your household.

The Obama administration granted some wiggle room amid the last-minute enrollment rush. Those who print out a paper form and mail it in now have an April 7 deadline.

Online applicants who start by March 31 can check a special box to say they’re trying to enroll, allowing them to finish during a grace period after the deadline.

Then there’s that penalty. People who don’t do any of the above will be asked to meet what the law calls the “individual shared responsibility provision.”

The IRS says this tax penalty for 2014 will be the greater of 1 percent of your household income or $95 per uninsured adult and $47.50 per uninsured child, up to a family maximum of $285. Total penalties are capped at the cost of the national average premium for a low-level health plan available through the Obamacare marketplace, the IRS says.

If you don’t make enough money to have to file a tax return, you won’t have to pay a penalty.

Other articles in this series:

How much will it cost me to enroll?

Did the enrollment drive succeed?

What if I haven't signed up yet?

of stories this month > Get unlimited stories
You've read  of  free articles. Subscribe to continue.

Unlimited digital access $11/month.

Get unlimited Monitor journalism.