Financial Help & Taxes

ACE TA Center

Taxes may not be fun, but they play an important role in helping make health coverage more affordable. Below is information on:

This information is accurate for filing 2023 taxes. The federal tax filing deadline is April 15, 2024. 

Tax filing for individuals with health coverage through the Marketplace 

Regardless of where they live, all clients who enrolled in health coverage through the Marketplace and received an advance premium tax credit (APTC) must file a federal tax return to make sure they received the amount of financial help they were eligible for, based on their actual income during the year. This process is called tax reconciliation.

Clients who did not receive an APTC may still be eligible to get the credit as a lump sum at the end of the year, especially if their income changed during the year, but they will need to file a tax return to find out.

Download this ACE TA Center tool to share with clients to help them understand the relationship between health coverage and taxes, and how to reconcile APTCs through tax filing.

States with individual mandates on proof of coverage

Starting with calendar year 2019, individuals are no longer required to show proof of health insurance on federal tax returns and will not have to pay a federal fee for not having insurance.

However, a number of states have implemented state-level individual mandates, and people in those states will be required to show proof of coverage when filing their state taxes or may have to pay a state penalty.


Effective Date

Penalties for Non-Coverage


Jan. 1, 2020



Jan. 1, 2006


New Jersey

Jan. 1, 2019


Rhode Island

Jan. 1, 2020



Jan. 1, 2020


Washington D.C.Jan. 1 , 2019Yes

Visit the websites above to learn more about the requirement to have health insurance in each state.

Related resources on tax filing

  • Understanding Premium Tax Credits and Cost-Sharing Reductions eLearning Module 
    Need to learn about what financial help is available for consumers who get health coverage through the Marketplace? Through this interactive eLearning module, HIV program staff will learn about premium tax credits, cost-sharing reductions, and how these and other resources can help Ryan White HIV/AIDS Program (RWHAP) clients pay for their health insurance and reduce out-of-pocket costs.
  • FAQ: Premium Tax Credits & Cost-Sharing Reductions
    In this FAQ, read an overview of how PTCs and CSRs can help clients pay premiums and lower the amount they have to pay out-of-pocket for deductibles, coinsurance, and co-payments.
  • Free tax help for qualifying taxpayers 
    The Volunteer Income Tax Assistance (VITA) program and Tax Counseling for the Elderly (TCE) program offer free tax help to qualifying taxpayers with incomes below $64,000 and seniors aged 60 or older, respectively. Learn more about the VITA and TCE programs here. The IRS FreeFile program is available to qualifying taxpayers with an adjusted gross income below $79,000. 
  • Taxes and Health Coverage - Resource for People with HIV
    This tool is designed to help clients understand the relationship between Marketplace health coverage and taxes and how to reconcile advance premium tax credits (APTCs) through tax filing. 

We'd like your feedback

Was this page helpful?
I found this page helpful because the content on the page:
Check all that apply
I did not find this page helpful because the content on the page:
Check all that apply
Please include an email address if you would like a response
Please include an email address if you would like a response
Did you use this approach in your work?
Not yet because
If no, why not?