What You Need To Know About The Affordable Health Care Act

by Louis Bongiovanni

The Affordable Care Act, aka Obamacare, inserted health insurance into tax season in two ways, affecting nearly all of us. The first is the law’s mandate that almost all U.S. residents get health coverage or pay a penalty. The second is the tax-credit subsidy millions of Americans received via Obamacare’s exchanges to lower their health insurance premiums.

Before you freak out, rest assured that little has changed for about 80% of Americans. Still, some people will have to jump through new hoops, and might see big effects on their tax refunds or bills.

I Get Health Coverage From An Employer Or A Government Program Such As Medicare Or Medicaid

When you file your return, you hardly have to do anything different. There’s a new line on the
1040 where you attest that you do, in fact, have health coverage. If that’s the case, then mark it down here, and you’re done.

Make sure it’s true that everyone in your household was covered, though, including those who may have had different insurance from you. For the more than 8 in 10 Americans who have one of these forms of coverage, tax filing is pretty much business as usual this year.

I Bought My Health Insurance From An Obamacare Exchange And Got Tax Credits

The good news is, tax credits made your health insurance more affordable. The bad news is you now have to prove you still have insurance, and that you didn’t get too much or too little of a subsidy. If your tax credit was too large, you’ll have to pay back at least some of it.

But first, you’ll need one of those new forms, a Form 1095-A. The health insurance exchanges for each state, whether federal- or state-run, will send these to households that bought private insurance policies from them (as opposed to Medicaid or the Children’s Health Insurance Program). This is your proof of insurance.

Those 1095-A forms are supposed to arrive in your mailbox by Feb. 2, 2015 so be on the lookout. You also can download them from the exchange website or call the exchange and ask it to send you one. You may get more than one form, depending on how each member of the family is covered. If you see any inaccuracies on these documents, contact your insurance exchange.

The 1095-A shows how much your total insurance premium was and how large a tax credit you got each month you were covered. You’ll need that information to fill out another form, called Form 8962 which is part of your personal income tax return.

When you applied for a credit, you told the exchange what you expectedto earn in 2014, and that number was used to calculate your subsidy. Now, when you file the Form 8962 with your taxes, you’re running the numbers again based on what you really made. If those amounts are different, your tax credits have to be adjusted. Those who owe the IRS can set up payment plans.

I Have Health Insurance That Isn’t From A Job Or The Government And I Didn’t Get Any Tax Credits

About 15% of people who bought their policies through an exchange didn’t get subsidies, and a few million more bought policies directly from an insurance company, bypassing the exchanges. These folks have to do more than people with job-based insurance or Medicare, but less than their subsidized neighbors.

Basically, if you bought an unsubsidized plan from an Obamacare exchange, take the information from your 1095-A and put it on your Form 8962, and check off line 61 of your 1040. If you didn’t use an exchange, you just need to care about line 61. When it comes to taxes, that counts as easy.

One more thing for unsubsidized people who used an exchange: You might still be able to get tax credits. If you earned less than four times the federal poverty level – $46,680 for a single person and $95,400 for a family of four — you can apply for a subsidy via the exchange. If you skipped the exchange, then this isn’t possible, no matter what your income was.

I Don’t Have Health Coverage At All

Obamacare’s individual mandate requires most legal U.S. residents to get covered, so you might be subject to a tax penalty if you were uncovered for more than three months. The formula is complicated, but the penalty starts at $95 and goes all the way up to about $11,000. If you didn’t earn enough money to pay taxes, meaning you made less than $10,150 as a single person under 65 or more for other types of households, then there’s no health insurance mandate for you, and you don’t have to file a return.

There are quite a few exceptions to the Obamacare mandate, but you must apply for most of them. The majority of exemptions are granted by the IRS, but some have to come from the exchange. You’ll need Form 8965 to include a mandate exemption on your tax return.

The idea behind the mandate was that everyone who can “afford” insurance should buy it, to avoid saddling the rest of us with the cost of their medical care. The Affordable Care Act says insurance is “affordable” if it costs 8 percent of your income. If insurance was available to you below that price and you didn’t get coverage, you’ll have to pay a penalty.

If you really couldn’t find “affordable” coverage, then you’re exempt. But you do have to document that to the IRS. Other exemptions you can claim on your tax return include living abroad or being in prison. For some exemptions, though, you’ll have to apply to your insurance exchange. Those include belonging to a religion that objects to insurance, or living in a state that didn’t expand Medicaid under Obamacare and left you ineligible for low-cost or free coverage, or getting your pre-Obamacare insurance policy canceled. And the exchanges will provide “hardship” exemptions for a slew of reasons, like being evicted or filing for bankruptcy.

You can file your taxes and claim those exemptions while waiting for your exchange to tell you whether you’re exempt. If it says no, then you can sort that out with the IRS later.