Application for Hardship Exemption to ACA Mandate
Starting in 2014, every person needs to have health coverage or make a payment on their federal income tax return called the "shared responsibility payment."
Some people are exempt from making this payment. This application includes one category of exemption. There are other applications for other categories of exemptions. You may apply for certain other categories of exemptions when you file your federal income tax return.
They have updated the documentation and instructions in 2017 and the new version is attached.