Skip Navigation Accessibility

Special Enrollment Opportunity Offered to Uninsured District Residents to Get Covered and Minimize Tax Penalty

Friday, February 15, 2019

Additional 60 days to enroll given to uninsured residents who learn of DC’s individual responsibility requirement when they file their 2018 DC taxes

Washington, DC - This week, the DC Health Benefit Exchange Authority (DCHBX) Executive Board adopted a unanimous recommendation from its Standing Advisory Board to allow a Special Enrollment Period (SEP) for District residents who may be subject to a District tax penalty because they did not have health insurance in 2019. A new District of Columbia law went into effect January 1, 2019 requiring residents to have health insurance, get an exemption or pay a penalty on their DC taxes. Some DC residents are learning about this individual responsibility requirement for the first time as they file their 2018 tax returns.

Uninsured District residents who learn of the individual responsibility requirement when filing their 2018 income taxes are now eligible for a 60-day Special Enrollment Period to enroll in health insurance through DC Health Link and minimize the impact of the tax penalty. If an uninsured resident contacts DC Health Link before they file their 2018 taxes, the 60-day SEP starts the day the individual contacts DC Health Link. If an uninsured resident contacts DC Health Link after they file, the SEP starts the date they filed their 2018 taxes. DC residents eligible for Medicaid are not subject to the tax penalty.

"As District residents prepare to file their taxes this year, some residents are just now learning that they may have to pay a local tax penalty for not having health coverage in 2019," said Diane C. Lewis, M.P.A., Chair of the DC Health Benefit Exchange Authority Executive Board. "We want to make sure that District residents who are uninsured and didn't know about DC's individual responsibility requirement are able to enroll in quality, affordable health insurance so they can minimize the impact of a tax penalty."

The tax penalty is based on the number of months an individual or family goes without health coverage. For someone who goes without coverage for a full year, the penalty is: $695 for each adult and $347.50 for each child, up to $2,085 per family or 2.5% of family income that is over the federal tax filing threshold, whichever is greater. For more details about the tax penalty visit: https://dchealthlink.com/individual-responsibility-requirement

Uninsured District residents who do not enroll during this Special Enrollment Period will not be able to sign up for coverage until the 2020 Open Enrollment Period, which starts November 1, 2019, unless they experience a life event that permits them a special enrollment opportunity (e.g. getting married or moving into the District). These uninsured residents may be subject to a penalty when they file their 2019 District of Columbia income taxes. Residents who are eligible for Medicaid can enroll in coverage through DCHealthLink.com throughout the year and are exempt from the District’s new penalty.


Background

The Federal Government repealed the penalty associated with the federal individual responsibility requirement from the Affordable Care Act (ACA) in the Tax Cuts and Jobs Act of 2017. In order to provide market stability and to maintain lower premium increases, the District of Columbia implemented its own local individual responsibility requirement that became effective January 1, 2019.

There are 25 private health insurance options from CareFirst Blue Cross Blue Shield and Kaiser Permanente for individuals and families. Eligible District residents can enroll in a health insurance plan online through DCHealthLink.com or by calling (855) 532-LINK [5465]. Small businesses—as well as individuals and families eligible for Medicaid—can enroll through DCHealthLink.com at any time.

Follow us on Facebook, Instagram and Twitter at @DCHealthLink