If you can't afford a health insurance policy, you can look into low income health insurance options for coverage. Programs like Medicaid and CHIP can offer low-cost or free health insurance so you don't have to pay the full cost of your medical bills. Previously, the Affordable Care Act included a tax penalty for not having health insurance coverage. As of January 2019, there is no federal fee if you don't have health insurance, although some states do have penalties.