How the Affordable Care Act Impacts Your Taxes

Beginning this tax season, you may notice some changes on your tax return related to the Affordable Care Act.  

Below is a guide to help inform you of potential changes.  Find the description that best represents your current situation.

  • I enrolled in a health plan through my employer, private insurance, Medicare or Medicaid
    • You're all set! All you will need to do is indicate that you have minimum essential coverage, a term that includes individual market policies, job-based coverage, Medicare, Medicaid, CHIP, TRICARE and certain other coverage.  For a full list of qualifying plan types, click here
    • New Tax Forms to Expect:
      • Form 1095-C: Your employer may provide a separate Form 1095-C to you and to the IRS, which provides information about your plan and who was covered
      • Form 1095-B: Private insurers and self-funded plans may provide each policyholder and the IRS with information summarizing the coverage provided on Form 1095-B
      • Note: This year is a transition period for Forms 1095-B and 1095-C, so these forms are not a requirement for Tax Year 2014
    • What I need from you:
      • All of the documentation you typically provide
      • Form 1095-C or 1095-B, if you received it from your employer or private insurer
  • I purchased a health plan through a Health Insurance Marketplace
    • Let us know that you purchased your plan through a Health Insurance Marketplace/Health Exchange
    • Did you receive a government subsidy in the form of a tax credit to purchase health insurance through the Health Insurance Marketplace?
    • This tax credit or subsidy could be applied to insurance premiums throughout 2014 when your coverage began.  Whether or not you choose to receive this subsidy during the tax year, you must reconcile your credit on your tax return
    • If you overestimated your 2014 household income when you applied for the tax subsidy, then you will receive the remainder of the subsidy in the form of a refundable credit, which will increase the refund amount or decrease the amount owned on your tax return.  But if you earn more than you projected, you will have to pay a portion or all of the subsidy back, which will decrease the refund amount or increase the amount owed on your tax return
    • In addition to a change in income, make sure to report all life changes (getting married or having a child) through your Marketplace to ensure your subsidy is correct
    • New Tax Forms to Expect:
      • Form 1095-A: If you purchased insurance through the Health Insurance Marketplace, then you will receive a new form, Form 1095-A, which will show details of your insurance coverage including the effective date, amount of premium and the advance premium tax credit
      • Form 8962: If you are eligible to receive a premium tax credit in 2014, information about your advance premium tax credit will be reported and the actual premium tax credit will be determined on Form 8962
    • What I need from you:
      • All of the usual documentation you provide
      • Form 1095-A, if you purchased health insurance through the Health Insurance Marketplace
  • I don't have health insurance
    • Under the ACA, individuals who did not have health insurance for more than three months in 2014 must pay a tax penalty.  However, you may qualify to waive the penalty
    • How do I know if I qualify for an exemption? The ACA recognizes there are legitimate reasons people may be exempt from paying a tax penalty for not having health insurance:
      • Can't afford health insurance; the lowest-priced coverage available would cost more than 8 percent of your household income
      • Had medical expenses you couldn't pay in the last 24 months that resulted in substantial debt
      • Had an individual insurance plan cancelled, and believe other marketplace plans are unaffordable
      • Received a shut-off notice from a utility company
    • For the full list of exemptions, click here
    • If you have been uninsured for fewer than three consecutive months of the year, then you don't need to apply for an exemption
    • If you are not required to file a tax return because your income is too low, then you don't need to apply for an exemption
    • Different exemptions require different forms, so be sure to apply with the correct document
    • You can find and print all of the forms, click here
    • For those exemptions that should be filed through the Health Insurance Marketplace, the approval process can take a couple of weeks, so don't wait until we file your taxes to apply for an exemption.  Submit your application as soon as possible
    • What I need from you:
      • All of the usual documentation you provide
      • If you are getting an exemption through the Health Insurance Marketplace/Exchange and not claiming the exemption directly on the tax return, then you will also need to provide the exemption certificate number.
    • What if I'm not exempt?
      • If you don't have health insurance and you don't qualify for an exemption, then you will have to pay a penalty when you file your 2014 tax return
      • The penalty (individual shared responsibility payment), is based on your family size and income.  The penalty will be prorated based on the number of months you are uninsured and will increase each year
      • For Tax Year 2014, the annual one-time tax penalty will be $95 per adult or 1% of your total income, whichever is greater.  For uninsured children in your family, the penalty is $47.50 per child, with a family maximum of $285 for the year.  The tax penalty is assessed on your 2014 tax return
      • In 2015 the penalty is $325 per adult, $162,50 per child or 2% of your income, whichever is greater
      • In 2016, the penalty is $695 per adult and $347.50/per child or 2.5% of your household income, whichever is greater