Passed in 2010, the Affordable Care Act overhauls the U.S. healthcare system and affects nearly all taxpayers, many employers and various elements of the healthcare industry.
The Act represents the most significant change to our healthcare laws since the passage of Medicaid and Medicare in 1965. The new law will be phased in over multiple years spanning 2009 to 2018, with the individual mandate taking effect Jan. 1, 2014. The new healthcare law uses the tax code and tax return in many respects to implement its measures.
Intuit® recently hosted a webinar presented by Mike D’Avolio on the Act.
4. Intuit Confidential4
You need to be
insured in 2014
Key Exemptions…
Financial hardship
Lowest cost plan exceeds 8% of
your household income
Your income is below tax-filing
threshold
Individuals without coverage for
less than 3 months
And others…
Without insurance, you
risk incurring a tax
penalty
6. Intuit Confidential6
Businesses with 50 or more full-time employees
must offer it
• Penalty: $2K/yr. for every employee
starting with the 31st
employee
Employer-sponsored insurance
Businesses with fewer than 50 full-time employees
are exempt
Tax credits available for employers who offer
insurance
• Eligibility: ≤25 employees; avg. wages ≤$50K;
employer covers ≥50% of coverage
Affordable options are available (e.g. HRA, HSA)
7. Intuit Confidential7
Health Exchanges
Public exchanges will be available in all 50 states
Plans have four levels of coverage: Platinum, Gold, Silver and Bronze
Subsidies available for those that are financially eligible
All plans offer “minimum essential coverage”
Private exchanges are an alternative
8. Intuit Confidential8
Are you eligible for a subsidy?
Determine your household size
Determine your household income
If it falls within the guidelines relative to the Federal
Poverty Line, you’re eligible:
Persons in
household
Federal Poverty Line
($/yr.)
Income Level Premium as a Percent of
Income
1 $11,170 Up to 133% FPL 2% of income
2 $15,130 133-150% FPL 3 – 4% of income
3 $19,090 150-200% FPL 4 – 6.3% of income
4 $23,050 200-250% FPL 6.3 – 8.05% of income
5 $27,010 250-300% FPL 8.05 – 9.5% of income
6 $30,970 300-400% FPL 9.5% of income
7 $34,930
8 $38,890
1
2
3
Stay tunedfor an Intuitsubsidycalculator!
9. Intuit Confidential9
Can’t afford insurance?
17%†
83%††
Meet Mary, a school teacher and a single mother with one child. She
earns $45K a year. Based on her subsidy, the state covers 17% of her
premium:
% of Premium Paid by Mary
Assumes annual premium of $5,160. †
Amounts to $885; † †
Amounts to $4,275
12. Fact: The penalty can be significant.
In 2016…
• The penalty is the greater of $695/yr.
OR
• 2.5% of income
Examples:
Family of 4 earning $25K would pay $695
Family of 4 earning $100K would pay $2,500
13. Intuit Confidential
The penalty is phased in over time
13
Flat fee portion % of household
income portion
2014 $95 1%
2015 $325 2%
2016 $695 2.5%
15. Intuit Confidential
Fact: There are things you can do this year!
• April 15th
, 2013: Keep your 2012 tax return as it will
determine your subsidy-eligibility
• October 1st
, 2013: You can start enrolling in a insurance
plan on public exchanges
• January 1st
, 2014: Make sure you’re insured!
Editor's Notes
The Affordable Care Act was passed in 2010. It overhauls the U.S. healthcare system and affects nearly all taxpayers, many employers and various elements of the healthcare industry. This represents the most significant change to our healthcare laws since the passage of Medicaid and Medicare in 1965. The new law will be phased in over multiple years spanning 2009 to 2018, with the individual mandate taking effect on January 1, 2014. The new healthcare law uses the tax code and tax return in many respects to implement its measures.
Exemptions will be granted for: Financial hardship; Religious objections; American Indians; Individuals without coverage for less than 3 months; Aliens not lawfully present in the U.S.; Incarcerated individuals; Individuals whose lowest cost plan option exceeds 8% of household income; or Individuals with income below the tax filing threshold ($9,750 single; $19,500 married filing joint)
You have several options to get health insurance… Job-based coverage : If your employer offers health insurance coverage, you may be eligible to receive it (including your spouse or dependents). Employers may decline or restrict coverage for certain reasons (part-time worker), but not for health reasons. Private policy: Beginning in 2014, these plans will cost the same whether acquired directly or through an exchange. However, subsidies apply only if you ’re using an exchange. Medicaid: Each state offers this program for lower income people, the elderly and people with disabilities. Health Insurance Marketplace (exchange): Beginning in 2014, this program helps you find health insurance that fits your budget. When you use an exchange, which are run by the state or federal government, it results in a private insurance policy (the government does not issue the policy).
Many Americans believe that the exchange is where they can go to get enrolled into a new government run insurance plan, which will be offered along with the private health care insurance plans currently available in the market today. This is not the case. There is no government run insurance plan or single payor system established under the Affordable Care Act. The government will only run the exchanges; the insurance industry will still be run by private companies.
Based on the table, 9.5% of her income (or $4,275) needs to be applied to insurance. Assume that an average annual premium equals $5,160. $4,275 divided by $5,160 is around 83%. Consequently, Mary pays 83% of premium and the subsidy covers 17%.
Beginning in October 2013, uninsured Americans will be able to enroll in a health plan through state and federal exchanges. Your 2012 tax return will help determine your eligibility for an insurance subsidy from the government, which will help you purchase health insurance under the health care law. There is noting special to do; your tax return determines eligibility. In 2014 everyone, except for a few, will be required to purchase health insurance or face a tax penalty.