Code of the District of Columbia

§ 47–5102. Requirement to maintain minimum essential coverage; exemptions.

(a) Beginning for tax years after December 31, 2018, and except as provided in subsection (b) of this section, an applicable individual shall, for each month, ensure that the applicable individual, and any dependent of the applicable individual who is also an applicable individual, maintains minimum essential coverage.

(b) Except as provided in paragraphs (1) and (2) of this subsection, the exemptions available from the federal requirement to maintain minimum essential coverage under section 5000A of the Internal Revenue Code of 1986 (26 U.S.C. § 5000A) and its implementing regulations, as such section and its implementing regulations were in effect on December 15, 2017, shall also be available as exemptions from the requirement to maintain minimum essential coverage contained in subsection (a) of this section, with the following modifications:

(1) Determinations as to hardship exemptions shall be made by the Authority under § 47-5104(b) rather than by the Secretary of the U.S. Department of Health and Human Services pursuant to section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act of 2010, approved March 23, 2010 (124 Stat. 177; 42 U.S.C. § 18031(d)(4)(H)).

(2)(A) The requirement imposed by subsection (a) of this section shall not apply to:

(i) Taxpayers who are 21 years of age or older as of the last day of the tax year and whose federal adjusted gross income for the taxable year is equal to or less than an amount equal to 222% of the federal poverty level as published by the Authority in accordance with subparagraph (B) of this paragraph;

(ii) Taxpayers who are 20 years of age or younger as of the last day of the tax year and not claimed as dependents on another individual's tax form, and whose federal adjusted gross income for the taxable year is equal to or less than an amount equal to 324% of the federal poverty level, as published by the Authority in accordance with subparagraph (B) of this paragraph;

(iii) A dependent who is 21 years of age or older as of the last day of the tax year and claimed as a dependent by a taxpayer whose federal adjusted gross income for the taxable year is equal to or less than an amount equal to 222% of the federal poverty level as published by the Authority in accordance with subparagraph (B) of this paragraph; or

(iv) A dependent who is age 20 years of age or younger as of the last day of the tax year and claimed as a dependent by a taxpayer whose federal adjusted gross income for the taxable year is equal to or less than an amount equal to 324% of the federal poverty level as published by the Authority in accordance with subparagraph (B) of this paragraph.

(B)(i) The Authority, after consultation with the Director of the Department of Health Care Finance, shall publish the qualifying income levels described in subparagraph (A) of this paragraph for each taxable year based on federal poverty levels using the poverty guidelines announced by the Secretary of the U.S. Department of Health and Human Services under the authority of section 673(2) of the Community Services Block Grant Act, approved October 27, 1998 (112 Stat. 2729; 42 U.S.C. § 9902(2)).

(ii) The qualifying income levels shall be for the number of individuals that include the taxpayer, the taxpayer's spouse, and any dependents claimed by the taxpayer on the taxpayer's income tax return for that taxable year.

(iii) The Authority shall publish the qualifying income levels for the taxable year within 60 days after the announcement of the poverty guidelines announced by the Secretary of the U.S. Department of Health and Human Services for that taxable year.

(C) The percentages identified in subparagraph (A) of this paragraph may be adjusted by the Mayor if the eligibility level changes for:

(i) Medicaid;

(ii) The Children's Health Insurance Program; or

(iii) The Immigrant Children's Program.


(Oct. 30, 2018, D.C. Law 22-168, § 5002(b), 65 DCR 9388.)

Emergency Legislation

For temporary (90 days) creation of this section, see § 5002 of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) creation of this section, see § 5002 of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).