Massachusetts, Vermont, Rhode Island require health insurance coverage

Only a handful of U.S. states require all residents who can afford it to have health insurance coverage, and three of them are in New England.

Passed in 2010, the Affordable Care Act, also known as Obamacare, mandated health insurance for nearly all Americans, but Congress later repealed the individual mandate penalty in 2017, meaning individuals would no longer be punished financially at the federal level for not having health insurance.

Today, an estimated 26 million people in the U.S. are currently without health insurance coverage.

In 2022, only five states and the District of Columbia require health insurance coverage at the state-level through local versions of individual mandates. In New England, Massachusetts, Vermont and Rhode Island all mandate health insurance for eligible residents − meaning if someone cannot afford health insurance or has experienced a particular hardship, they will not be penalized. New Jersey and California also require all residents be enrolled in a health insurance plan.

Only five states and the District of Columbia require eligible residents to have health insurance through state-level individual mandates.

The U.S. is in the midst of its annual open enrollment period, when people can enroll in a health insurance plan for the following calendar year. People are encouraged to enroll by Dec. 15 for coverage that starts Jan. 1. The enrollment period runs through Jan. 15, 2023 in most states.

This year’s open enrollment is particularly critical, as up to 15 million Americans could lose Medicaid coverage when the COVID-19 federal public health emergency ends, according to the Department of Health and Human Services − in some cases for reasons as simple as not having updated an address or contact information.

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