Health Care Reform

February 14, 2019

Thanks to the tax reform, beginning in 2019, the penalty for not having adequate health insurance, which the government refers to as the “individual shared responsibility payment,” will no longer apply.

September 27, 2018

The Affordable Care Act (Obamacare) included a “shared responsibility payment,” which in reality is a penalty for not having health insurance. Along with this penalty came a whole slew of exemptions from the penalty, including some that were designated as “hardship” exemptions. However, the hardship relief from the penalty required pre-approval from the government health insurance marketplace, which required the applicant to provide documentary evidence of the hardship. Once approved, the applicant was issued an exemption certificate number (ECN) that needed to be included on the individual’s tax return to avoid the penalty.

May 9, 2017

The House of Representatives on May 4, 2017, by a vote of 217 to 213 down party lines, passed the GOP's proposed American Health Care Act (AHCA). The AHCA would repeal and replace several provisions of the Affordable Care Act (ACA). It next goes to the Senate, where it will no doubt receive some modifications even if it does pass. It needs only a simple majority to pass the Senate and cannot be filibustered.

March 8, 2017

On March 6, the House Republicans unveiled their draft legislation that would repeal and replace the Affordable Care Act (ACA). In general, the GOP’s plan would continue the ACA’s premium tax credit through 2019 and then replace it in 2020 with a new credit for individuals without government insurance and those who are not offered insurance by their employer. However, most of the ACA’s insurance mandates and penalties would be repealed after 2015. Other provisions will be overturned periodically through 2019.

October 6, 2016

When an individual itemizes deductions, one of those deductions is the cost of medical and dental expenses, including health insurance premiums. However, the medical expense deduction has been historically limited to the amount that exceeds 7.5% of a taxpayer's adjusted gross income (AGI).

September 22, 2016

Individuals who procure their health insurance through a government marketplace may qualify for the advance premium tax credit (APTC), which is used to reduce the cost of their insurance premiums. The reason it is called an “advance” premium tax credit is because the marketplace estimates the amount of the premium tax credit (PTC) that individuals will ultimately qualify for when they file their tax returns for the year. The estimation is based on information the individual provides the marketplace as to the amount of anticipated household income and family size. APTC is provided to reduce the financial burden of having to pay the full premium amounts during the year and then receiving the credit after the fact.

May 19, 2016

Everyone hates to get letters from the IRS, and if you claimed the Premium Tax Credit (PTC) on your tax return or obtained your insurance through one of the federal or state insurance Marketplaces and had your premiums subsidized with the Advance Premium Tax Credit (APTC), your odds of receiving correspondence from the IRS will increase substantially. This is due to the complexity of the Affordable Care Act (ACA) and its maze of tax reporting requirements to ensure taxpayers correctly comply with the ACA's many provisions.

July 19, 2016

When Congress came up with the Affordable Care Act (ACA), they carved out two basic categories of businesses, those with 50 full-time employees and/or full-time equivalent employees (FTEEs) and those with fewer than 50 employees. Under the ACA, businesses in the first category have a requirement to offer affordable insurance to their full-time employees and their dependents. If you are an employer with fewer than 50 full-time employees or FTEEs, you are not subject to the insurance requirement, but there are still some ACA issues you need to be aware of.

June 30, 2016

One of the key provisions of Obamacare is the premium tax credit (PTC), which serves as a subsidy for the cost of health insurance for lower-income individuals and families. Although the credit is determined at the end of the year based upon income, taxpayers are allowed to estimate their income and receive the credit in advance, thereby reducing their premium costs.

March 3, 2016

Many taxpayers are surprised by the size of the penalty being imposed for not having health insurance in 2015. This may be a wake-up call for many who didn't realize the penalty is being phased in over a three-year period between 2014 and 2016, and the increases are substantial each year.

February 9, 2016

Under the Affordable Care Act, certain employers – referred to as applicable large employers (ALEs) – are subject to the employer shared responsibility provisions, which require ALEs to offer affordable minimum essential coverage healthcare coverage that provides minimum value to full-time employees and their dependents (but not their spouses). Failure to do so can result in the employer being liable for substantial penalties that the government refers to as shared responsibility payments.

January 21, 2016

Beginning for the 2015 tax year, Applicable Large Employers (ALEs) are required to file Forms 1095-C and 1094-C with the IRS and provide a copy of the 1095-C to each of their employees. An ALE is generally an employer with 50 or more equivalent full time employees (EFTEs) in the prior year. Even though ALE’s with 99 or fewer EFTEs are not subject to the insurance mandate for 2015, they are subject to the 1094-C and 1095-C filing requirements for 2015.

October 1, 2015

If you are one of the many individuals or families who purchase their health insurance through the federal or a state government health insurance marketplace and are receiving an advance premium tax credit (subsidy of premium available to those with low to moderate income) to help you pay the cost of that insurance, you should make sure you report changes in family income and family size, as they occur, to the marketplace through which you purchased your insurance.

October 22, 2015

A tweet from an Indiana resident by the name of Benjamin Miller, including a picture of the IRS notice he received advising him that he owes $2,344 as a penalty for not having health insurance, has gone viral and ignited a firestorm.

December 1, 2015

When applying for insurance through a state or the federal health insurance marketplace, you will be asked to provide an estimate of your household income for 2016. Your household income is a key factor in determining if you are qualified for an insurance subsidy called the premium tax credit (PTC). Any premium tax credit that you are entitled to will be computed on your 2016 tax return when it is filed in 2017. However, the insurance marketplace will allow you to reduce your insurance premiums during the year by applying this credit in advance based upon the estimate of your household income you provided when applying for the insurance. This advance is referred to as the advanced premium tax credit (APTC).

December 10, 2014

Penalty Calculation - There is a penalty for not having health insurance unless one of several exemptions is met. The penalty is being phased in over three years. The monthly penalty for 2016, the final phase-in year, is the greater of $57.92 per uninsured adult plus $28.96 for each uninsured child (under age 18), but not to exceed $173.75 per month for a family, OR 2.5% of household income in excess of the individual’s income tax filing threshold divided by 12. Filing threshold is the sum of the standard deduction and personal exemption amounts for the filer and spouse, if any.

August 13, 2015

If you are one of the over 1 million individuals who received an Obamacare health insurance premium subsidy last year and have yet to file your 2014 tax return, you are risking your opportunity to receive a subsidy in 2016.

July 7, 2015

Beginning in 2015, large employers (those with 100 or more full-time equivalent employees) must begin offering health insurance coverage to their employees. Then, in 2016, employers with 50 or more equivalent full-time employees must do the same or face penalties, called the “large employer health coverage excise tax.”

June 25, 2015

Breaking: Supreme Court, in a 6-3 decision, upholds Affordable Care Act (Obamacare) subsidies. The ruling allows federal tax credits to be issued to people who buy health plans through a federally run

June 10, 2015

It has been five years since the Patient Protection and Affordable Care Act (the ACA) was signed into law. Healthcare reform has certainly been controversial, but this controversy does not absolve some businesses of certain responsibilities when it comes to offering minimum essential healthcare coverage to their employees.

April 23, 2015

The penalty for not having minimum essential health insurance for yourself and other members of your tax family takes a substantial jump in 2015. For 2014, the penalty was the greater of the flat dollar amount ($95 for each adult plus $47.50 for each child under age 18, but no more than $285) or 1% of your household income minus your tax-filing threshold amount. For 2015, those amounts take a substantial jump to $325 for each adult and $162.50 for each child (but no more than $975) or 2% of household income minus the amount of your tax-filing threshold.

February 10, 2015

The Affordable Care Act, the federal health care law, will bring some surprises at tax time for many. This year there are two new issues that can complicate the preparation of almost anyone's tax return. First, there is the shared responsibility payment, a nice name the government gave to the penalty for not being insured. So everyone who is uninsured is subject to a monthly penalty, assessed on the individual 1040 tax return, unless they meet one or more of the many exceptions to the penalty. Many of the exceptions are complicated and difficult to understand by a layman.

December 31, 2014

If you get health insurance coverage through a government Health Insurance Marketplace, it is very important that you keep the Marketplace aware of any changes in household income, marital status, and family size.

December 18, 2014

In general, beginning January 1, 2015, employers with at least 100 full-time and full-time-equivalent employees must offer affordable health coverage that provides minimum value to at least 95% of their full-time employees and their dependents or they may be subject to an employer shared responsibility payment. This payment applies only if at least one of the employer's full-time employees qualifies for a premium tax credit through enrollment in a government Health Insurance Marketplace.

December 9, 2014

If you didn’t get health insurance coverage this year, you may be subject to a penalty unless you qualify for one of the many general or hardship exemptions. There are in excess of 30 possible exemptions from the penalty and some of the exemptions require you to complete and file an application for approval. If approved for an exemption that requires specific approval, you will be issued an exemption certificate number (ECN) that must be included on your tax return to claim the exemption.

November 25, 2014

The IRS earlier this year cautioned employers of the consequences when an employer reimburses its employees for the cost of premiums the employees pay to purchase qualified health plans, either through a health insurance marketplace or outside the marketplace, rather than establishing a health insurance plan for its own employees.

November 4, 2014

If you are enrolled in insurance coverage through a government Health Insurance Marketplace, it is important that you report certain changes to the marketplace when they happen, such as changes to your household income or family size and other issues that affect your eligibility for and the amount of the advance premium tax credit (APTC). The APTC is used to reduce the amount you must pay for your monthly health insurance premiums.

October 23, 2014

Obamacare – or, more officially, the Affordable Care Act (ACA) – insurance mandate, along with its health insurance premium subsidies available from insurance marketplaces, premium tax credit (PTC), and penalty for not being insured, is going to affect just about every taxpayer in one way or another.

June 24, 2014

The Affordable Care Act (ACA), also referred to as Obamacare, imposes an individual mandate requiring all non-exempt U.S. Citizens and legal residents to enroll in government-approved health insurance in 2014 or pay a penalty. The penalty will be collected through the individual’s income tax returns (Form 1040).

April 24, 2014

If you are signed up for health insurance through a health insurance marketplace, you may have qualified for the premium assistance tax credit. This credit provides financial assistance to help you pay for your health insurance premiums. Individuals and families that qualify for the credit are given the choice to receive the credit in advance to reduce the insurance premiums during the year, or they can pay the full insurance premiums and get the credit when they file their tax return next year.

April 15, 2018

As of 2014, the Affordable Care Act imposed the new requirement that all people in the United States, with certain exceptions, have minimum essential health care insurance or they will be subject to a penalty. How this affects your family will depend upon a number of issues. Penalty ends after 2018.

December 10, 2013

Beginning in 2010, the federal government offered small employers a tax credit as an incentive to provide health insurance to their employees. This credit was up to 35% of the employer's contribution toward the cost of the employees' health insurance for 2010 through 2013, with an increase to 50% starting in 2014, and then available only for two consecutive years after 2013. For non-profit employers, the credit percentages are 25% and 35%, respectively.

December 3, 2013

Beginning in January, everyone, with certain exceptions, is required to have minimum, essential health care insurance. This issue has received a significant amount of press coverage recently, both negative and positive. Regardless of your opinion related to the issue, the mandatory insurance requirement, together with the accompanying penalties for not being insured, premium assistance credits, and insurance subsidies, all begin in 2014. The new marketplace, also called exchanges, where insurance policies can be purchased, have debuted already, but with mixed success. These new provisions are all part of the Affordable Care Act (sometimes referred to as Obamacare) that are being phased in over a number of years.

November 21, 2013

There is a new additional Medicare tax in effect for 2013 that may require year-end actions. The new tax, which is part of the Affordable Care Act, imposes an additional 0.9% Medicare (HI) tax on some higher-income taxpayers. The threshold for paying the tax is combined wages and net self-employment income of over $250,000 for married individuals and $200,000 for others. (Taxpayers who do not have wage or self-employment income—for example, retirees or those with only investment income—are not subject to this new tax, regardless of the amount of their income.)

October 15, 2014

Certain employers must provide written notice to employees about health insurance coverage options available through the Marketplace (insurance exchanges).

September 17, 2013

Beginning Oct. 1, any business with at least one employee and $500,000 in annual revenue must notify all employees by letter about the Affordable Care Act’s health care exchanges. The requirement applies to any business regulated under the Fair Labor Standards Act (FLSA), regardless of size. Going forward, letters are to be distributed to any new hires within 14 days of their starting date, according to the Department of Labor.

September 10, 2013

As part of the Affordable Care Act (the new health care legislation), a new tax kicks in this year. The official name of this tax is the Unearned Income Medicare Contribution Tax, and even though the name implies it is a contribution, don’t get the idea that it is voluntary or that you can deduct it as a charitable contribution. It is actually a surtax levied on the net investment income of taxpayers in the higher income brackets. And although it is perceived as an additional tax on higher-income taxpayers, it can affect even those who normally don’t have higher income if they have a large income from the sale of real estate, stocks, or other investments.

February 6, 2014

The tax law provides a credit for small business employers who pay the health insurance premiums for their workers. This credit can be as much as 35% (25% for tax-exempt organizations) of the insurance premiums paid by the employer in 2013.

July 18, 2013

As part of the Patient Protection and Affordable Care Act (new health care law), employee contributions to health flexible spending arrangements (health FSA) are now being limited to a maximum pre-tax contribution of $2,500.

July 24, 2013

Beginning in 2014 the Patient Protection & Affordable Care Act (the health care legislation sometimes known as Obama Care) will impose the new requirement that U.S. persons, with certain exceptions, have minimal, essential health care insurance.

July 16, 2013

Beginning in 2015, large employers, generally those with 50 full-time employees in the prior calendar year, will be affected by the Patient Protection and Affordable Care Act. Watch the video to learn how it may affect you.

November 8, 2011

The tax law provides a credit for small business employers in 2010, 2011, 2012, and 2013 that pay the health insurance premiums for their low- to moderate-income workers. This refundable credit can be as much as 35% of the insurance premiums paid by the employer.