Among a lot of reasons: income-related, cultural, personal status, hardship exemptions, the first ones are very common. The mandate to own health insurance indicates that the ACA ensures that health insurance costs are kept reasonable for American families. But there are still come the cases of two exemptions from the individual mandate penalty based on low income: the first one is a case when a taxpayer’s annual income is low enough to avoid having to pay income tax and the second one is when the lowest-cost health insurance policy you can find costs more than 8 % of your total annual income of the household.