Tax Facts

8856 / If a taxpayer changes health coverage during a year and has a gap in coverage will the taxpayer be subject to the shared responsibility penalty?

Editor’s Note: The ACA individual mandate was repealed for tax years beginning after 2018. However, certain taxpayers may now be impacted by state-level mandates that mirror the ACA mandate.

A taxpayer is treated as having minimum essential health coverage for the month if covered for at least one day during that month. Therefore, if the coverage gap is less than one month, the taxpayer will not be treated as having a gap in coverage and will not be subject to the shared responsibility penalty.1

Further, an individual will not be subject to the shared responsibility penalty if the gap in coverage lasts for less than three months (see Q 8847). However, this exemption applies only to the first three-month gap in the tax year. If the taxpayer has more than one three-month coverage gap in the same tax year, he or she will be subject to the shared responsibility penalty with respect to the second coverage gap.2


1See IRS Questions and Answers on the Individual Shared Responsibility Provision, available at: https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-individual-shared-responsibility-provision (last accessed September 28, 2024).

2.  IRC § 5000A(e)(4).

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