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Is There a Penalty for Not Having Health Insurance in Maryland? (2027)
Short answer for Maryland: no. The federal penalty dropped to $0 starting in 2019, but a few states run their own.
The federal penalty
The ACA's individual mandate still technically exists, but Congress reduced the federal penalty to $0 beginning with tax year 2019. You won't owe anything on your federal return for being uninsured in 2027.
Maryland rules
Maryland has no state penalty for going without coverage, though the state tax return asks whether you had coverage so Maryland Health Connection can reach out to uninsured residents.
The real penalty: the bill
Even without a tax penalty, being uninsured is expensive:
- An emergency room visit with imaging can run several thousand dollars.
- A broken leg with surgery or a few days in the hospital can reach tens of thousands.
- Uninsured patients are usually billed the full "chargemaster" rate, far above what insurers pay.
Health insurance caps that risk. For 2027, an ACA plan's out-of-pocket maximum can't exceed $12,000 for one person, no matter how big the bill.
Other consequences
- You can't sign up whenever you want. Marketplace enrollment is limited to open enrollment or a life event. In Maryland, open enrollment for 2027 coverage runs on Maryland Health Connection from November 1, 2026 to January 15, 2027. Pick a plan by December 31, 2026 if you want coverage to start January 1, 2027; plans picked after that start later.
- Medicare late penalties are separate and permanent if you skip Part B or D when first eligible.
Cheap ways to avoid going uninsured
- Maryland expanded Medicaid, so adults earning up to 138% of the federal poverty level (about $22,025 a year for one person) can generally qualify for Maryland Medicaid.
- A subsidized bronze plan can be close to $0. See affordable options on a budget.
- Catastrophic plans for people under 30, or 30+ with a hardship exemption.
- Outside the marketplace, private shared-network plans are sold in Maryland on leased PPO networks (Cigna, Aetna and PHCS PPO). They're medically underwritten, so they ask health questions and price on age and health instead of income, but you can enroll any month and coverage starts on the 1st.
Check your options and we'll find the least expensive way to be covered.
Frequently asked questions
Is there a federal penalty for no health insurance in 2027?
No. The federal individual mandate penalty has been $0 since 2019.
Which states have a health insurance penalty?
California, Massachusetts, New Jersey, Rhode Island and Washington, D.C. charge a penalty on state tax returns for going without qualifying coverage.
Will I owe a penalty in Maryland if I'm uninsured?
Maryland has no state penalty for going without coverage, though the state tax return asks whether you had coverage so Maryland Health Connection can reach out to uninsured residents.