In the United States, it is not against the law to not have health insurance. However, the Affordable Care Act (ACA) introduced a penalty for individuals who do not have health insurance, which was effective from 2014 to 2018. This penalty was known as the individual shared responsibility payment. Since 2019, the penalty has been removed, and individuals are no longer required to have health insurance. However, it is still highly recommended to have health insurance to avoid high medical costs in case of illness or injury.