Affordable Care Act
The most frequently asked tax questions related to Affordable Care Act
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Answer Tax Questions2018-Premium tax credit
Asked Thursday, December 20, 2018 by an anonymous user
For 2018, you are required to have minimum essential health coverage through an employer plan, a government program, or other plan, or pay a penalty. The mandate does not apply after 2018.
To help those of modest means pay premiums for coverage obtained from a government exchange (Marketplace), there’s a premium tax credit . Eligibility for this advanceable, refundable tax credit depends on your household income and other factors.
The credit continues to be available even though the individual mandate ends after 2018.
To help those of modest means pay premiums for coverage obtained from a government exchange (Marketplace), there’s a premium tax credit . Eligibility for this advanceable, refundable tax credit depends on your household income and other factors.
The credit continues to be available even though the individual mandate ends after 2018.
Income levels to qualify for health premium credit
Asked Monday, October 31, 2016 by an anonymous user
The Income levels to qualify for health premium credit have increased. For fillers with household incomes ranging from 100% to 400% of the 2015 poverty level: $11,770 to $47,080 for singles and $24,250 to $97,000 for a family of four.
Maximum out of pocket cap
Asked Tuesday, November 25, 2014 by an anonymous user
The maximum out of pocket cap for 2016 will increase to $6,850 for an individual and $13,700 for a family policy.
The maximum out of pocket cap for 2017 will increase to $7,150 for an individual and $14,300 for a family policy.
The maximum out of pocket cap for 2015 will increase to $6,600 for an individual and $13,200 for a family policy.
The 2014 maximum out of pocket cap was $6,350 for an individual and $12,700 for a family policy.
The maximum out of pocket cap for 2017 will increase to $7,150 for an individual and $14,300 for a family policy.
The maximum out of pocket cap for 2015 will increase to $6,600 for an individual and $13,200 for a family policy.
The 2014 maximum out of pocket cap was $6,350 for an individual and $12,700 for a family policy.
Penalty for not having coverage
Asked Tuesday, November 25, 2014 by an anonymous user
In 2016, the penalty for not having health care coverage is the higher of 2.5 percent of your income or $695 per adult and $347.50 per child with a maximum penalty per family of $2,085
The penalty will be reported on your 2016 tax return.
In 2015, the penalty for not having health care coverage is the higher of 2 percent of your income or $325 per adult and $162.50 per child with a maximum penalty per family of $975.
The penalty will be reported on your 2015 tax return.
The penalty for not having health care coverage in 2014 was the higher of 1 percent of your income or $95 per adult and $47.50 per child with a maximum penalty per family of $285.
The penalty will be reported on your 2016 tax return.
In 2015, the penalty for not having health care coverage is the higher of 2 percent of your income or $325 per adult and $162.50 per child with a maximum penalty per family of $975.
The penalty will be reported on your 2015 tax return.
The penalty for not having health care coverage in 2014 was the higher of 1 percent of your income or $95 per adult and $47.50 per child with a maximum penalty per family of $285.
Phone assistance
Asked Tuesday, November 25, 2014 by an anonymous user
If you need help you can call the federal Health Insurance Marketplace at 800-318-2596.
Effective dates in 2013-14
Asked Tuesday, July 03, 2012 by an anonymous user
The U.S. Supreme Court declared on 6/28/12 the mandate in Sec. 5000A, requiring U.S. citizens and legal residents to maintain minimum essential health coverage, to be a permissible exercise of Congress's taxing powers under the Constitution.
The health care reform legislation added a number of new taxes and made various other revenue increasing changes to the IRS Code to help finance health care reform.
Medical care itemized deduction threshold (Sec. 213): Threshold for the itemized deduction for unreimbursed medical expenses is increased from 7.5% of adjusted gross income (AGI) to 10% of AGI for regular income tax purposes. (Effective 2013 generally, 2017 for certain taxpayers.)
Medicare tax on investment income (Sec. 1411): Imposes a tax on individuals equal to 3.8% of the lesser of the individual's net investment income for the year or the amount the individual's modified AGI exceeds a threshold amount. (Effective 2013.)
Additional hospital insurance tax on high-income taxpayers (Sec. 3101): Employee portion of the Medicare hospital insurance tax part of FICA is increased by 0.9% on wages that exceed a threshold amount. (Effective 2013.)
Health flexible spending arrangements (FSAs) (Sec. 125(i)): Maximum amount available for reimbursement of incurred medical expenses under a health FSA for a plan year (or other 12-month coverage period) must not exceed $2,500. (Effective 2013.)
Excise tax on medical device manufacturers (Sec. 4191): Tax equal to 2.3% of the sale price is imposed on the sale of any taxable medical device by the manufacturer, producer, or importer of the device. (Effective 2013.)
Premium-assistance credit (Sec. 36B): Refundable tax credits that eligible taxpayers can use to help cover the cost of health insurance premiums for individuals and families who purchase health insurance through a state health benefit exchange. (Effective 2014.)
Employer Penalty (Sec. 4980H): An "applicable large employer" that does not offer coverage for all its full-time employees, offers minimum essential coverage that is unaffordable, or offers minimum essential coverage that consists of a plan under which the plan's share of the total allowed cost of benefits is less than 60%, is required to pay a penalty if any full-time employee is certified to the employer as having purchased health insurance through a state exchange with respect to which a tax credit or cost-sharing reduction is allowed or paid to the employee. (Effective 2014.)
Reporting requirements (Sec. 6055): Requires insurers (including employers who self-insure) that provide minimum essential coverage to any individual during a calendar year to report certain health insurance coverage information to both the covered individual and to the IRS. (Effective 2014.)
Cafeteria plans (Sec. 125): A qualified health plan offered through a health insurance exchange is a qualified benefit under a cafeteria plan of a qualified employer. (Effective 2014.)
The health care reform legislation added a number of new taxes and made various other revenue increasing changes to the IRS Code to help finance health care reform.
Medical care itemized deduction threshold (Sec. 213): Threshold for the itemized deduction for unreimbursed medical expenses is increased from 7.5% of adjusted gross income (AGI) to 10% of AGI for regular income tax purposes. (Effective 2013 generally, 2017 for certain taxpayers.)
Medicare tax on investment income (Sec. 1411): Imposes a tax on individuals equal to 3.8% of the lesser of the individual's net investment income for the year or the amount the individual's modified AGI exceeds a threshold amount. (Effective 2013.)
Additional hospital insurance tax on high-income taxpayers (Sec. 3101): Employee portion of the Medicare hospital insurance tax part of FICA is increased by 0.9% on wages that exceed a threshold amount. (Effective 2013.)
Health flexible spending arrangements (FSAs) (Sec. 125(i)): Maximum amount available for reimbursement of incurred medical expenses under a health FSA for a plan year (or other 12-month coverage period) must not exceed $2,500. (Effective 2013.)
Excise tax on medical device manufacturers (Sec. 4191): Tax equal to 2.3% of the sale price is imposed on the sale of any taxable medical device by the manufacturer, producer, or importer of the device. (Effective 2013.)
Premium-assistance credit (Sec. 36B): Refundable tax credits that eligible taxpayers can use to help cover the cost of health insurance premiums for individuals and families who purchase health insurance through a state health benefit exchange. (Effective 2014.)
Employer Penalty (Sec. 4980H): An "applicable large employer" that does not offer coverage for all its full-time employees, offers minimum essential coverage that is unaffordable, or offers minimum essential coverage that consists of a plan under which the plan's share of the total allowed cost of benefits is less than 60%, is required to pay a penalty if any full-time employee is certified to the employer as having purchased health insurance through a state exchange with respect to which a tax credit or cost-sharing reduction is allowed or paid to the employee. (Effective 2014.)
Reporting requirements (Sec. 6055): Requires insurers (including employers who self-insure) that provide minimum essential coverage to any individual during a calendar year to report certain health insurance coverage information to both the covered individual and to the IRS. (Effective 2014.)
Cafeteria plans (Sec. 125): A qualified health plan offered through a health insurance exchange is a qualified benefit under a cafeteria plan of a qualified employer. (Effective 2014.)
