An individual mandate is a requirement that all persons procure a particular good or service. In health care, it referred to the controversial provision within the Affordable Care Act that most Americans, with some exceptions, were required to carry health insurance or pay a tax penalty. The Supreme Court upheld the ACA’s individual mandate as constitutional in 2012, but the major tax bill passed by Congress in 2017 eliminated the penalty beginning in 2019, which means you no longer pay a tax penalty for not having health coverage. Lacking a federal individual mandate, states can implement their own. As of 2024, four states ( all required their residents to carry health insurance or face a penalty.