20 Feb 2018

Trump Administration Continues to Pursue Avenues to Relieve People of the ACA’s Individual Mandate

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Trump Administration Continues to Pursue Avenues to Relieve People of the ACA’s Individual Mandate

The Patient Protection and Affordable Care Act, nicknamed Obamacare, was signed into law March 2010. The act’s major provisions came into effect in 2014. It was the most sweeping health care reform in America since the passage of Medicaid and Medicare back in 1965. Major changes to the individual insurance marketplace and an expansion of Medicaid Eligibility managed to provide coverage to an estimated twenty to twenty-four million additional people during the year 2016 alone.

In spite of the benefits that have been received by millions under the act, one of the least popular provisions of the act has been the individual mandate. This is a requirement that every American who is not insured through employer-sponsored plans, Medicaid, Medicare, or other private or public program must purchase insurance or pay a tax penalty.

Republicans have been the most vocal opponents of the individual mandate and have fought tooth and nail to find ways to repeal the act altogether, and in particular, eliminate the individual mandate. The Trump administration, through the Tax Cuts and Jobs Act of 2017 which was signed in December 2017, has taken a huge leap to chip away at Obamacare. The act repeals the individual mandate as of 2019.

That still leaves 2018 to be dealt with. The Centers for Medicare and Medicaid Services has endeavored to work on guidance aimed to increase the exemptions under which people would justifiably not show that they are insured when filing their year-end income tax returns. This could help scores of taxpayers who are still uninsured due to the increased cost of insurance plans under Obamacare. The IRS reports that six and a half million taxpayers paid the fine for not being insured in the year 2015.

The tax penalties can be hefty, starting at $347.50 per child, $695 for adults and going up to as high as $2,085 for a family. There is a cap of 2.5% of family income or the family maximum of $2,085 – whichever would be higher.

Currently, the exemptions to avoid paying the penalty are:

Hardship Exemptions

Those who are homeless, filed for bankruptcy, are facing eviction or a foreclosure or received a notice from a utility company that their service was being shut-off fall under the “Hardship Exemption.”  Additionally, those who suffered domestic violence, the death of a family member or a natural disaster also qualify to be exempt from the mandate.

Other hardships that also qualify for exemption consideration are; a) Tax filers who had medical expenses they couldn’t pay which resulted in substantial debt. b) Those who experienced unforeseen expenses due to caring for a family member who was aging, who was ill or was disabled. c) Your grandfathered individual insurance plan was canceled because it failed to meet the requirement for the ACA. d). Those eligible for subsidies, but the insurance company failed to provide them, and insurance was not available as a result.

Income Related Exemptions

If you don’t earn enough income during the year to be required to file a tax return, you will not have to pay a penalty.

For those whose costs of insurance, whether through a job-based or a Marketplace plan, would cost in excess of 8.16% of the household’s income, can qualify for either the Job-based affordability exemption or the Marketplace affordability exemption.

Group Membership Exemptions

Members of qualified health care sharing ministries will not face penalties.

Members of federally recognized tribes or those eligible for services through an Indian Health Services Provider are also exempt from penalties.

Exemptions Related to Health Coverage

Residents of states that did not expand its Medicaid program and the tax filer’s income falls below 138% of that state’s poverty level are exempt.

Legal Status Based Exemptions

Tax filers will not face penalties if they were incarcerated or residing abroad. U.S. Tax laws apply to all income earners, whether they are here legally or not. Undocumented immigrants must file a return if the minimum earnings threshold to file is met, however, they are excluded from the coverage requirement. They are also unable to obtain insurance through the marketplaces set up by the ACA.

Over 12 million people qualified under one or another of these exemptions for the tax year 2016. For the tax year 2017 and 2018, it will be even easier to duck the tax penalty. The Internal Revenue Service has backed off on enforcement of the mandate. Obamacare required the IRS to withhold returns if the taxpayer did not provide coverage information on the return. However, they had not enforced it rigorously. The IRS had previously announced that in the tax year 2017, they would step up enforcement, but with president Trump’s pressure, they have now retracted that statement.

It is still unclear what the final list of expanded exemptions will be, the CMS has not announced when they will complete their work on the guidance.

To learn more about qualified plans under Obamacare or Trumpcare, or additional insurance options, contact the experts at HealthQuoteInfo.com at 855-881-0430. Our licensed health insurance experts will be happy to answer any questions you have.