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ACA Hardship Exemptions

There are certain circumstances that affect an individual’s ability to purchase health insurance coverage and which may qualify an individual for a hardship exemption. To make the determination, the Marketplace considers whether an individual has experienced one of the following events:

Becomes homeless
Has been evicted in the past six months, or is facing eviction or foreclosure
Has received a shut-off notice from a utility company
Recently experienced domestic violence
Recently experienced the death of a close family member
Recently experienced a fire, flood, or other natural or human-caused disaster resulting in substantial damage to individual property
Filed for bankruptcy in the last six months
Incurred medical expenses in the last 24 months that resulted in substantial debt
Experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member
Expects to claim a child as a tax dependent who has been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, the individual would not have to make a payment for the child
As a result of an eligibility appeals decision, is determined eligible for enrollment in a QHP through a Marketplace, the premium tax credit, or cost-sharing reductions for a period of time during which he or she was not enrolled in a QHP through a Marketplace
Was determined ineligible for Medicaid because his or her state did not expand eligibility for Medicaid under the Affordable Care Act
Lost insurance coverage because his or her individual plan was cancelled and believes other available coverage options are unaffordable
Experiences another hardship in obtaining health insurance

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