Covered California consumers are penalized for having the good fortune of their household income’s increase. To add another layer of insult, if the consumer makes over 400% of the federal poverty level, they have to repay all the monthly tax credit subsidies they received during the year and pay for an artificially inflated Silver plan rate. Ouch!
In order determine how my clients might be affected by the proposed new Premium Tax Credits under the American Heath Care Act (AHCA or Trumpcare) introduced by the Republicans in March 2017, I compared the current income based Premium Tax Credits under the ACA to the new age based tax credits of the AHCA. On average, my clients included in the comparison will lose $157 per month to help pay for their health insurance. Young individuals, under 30 years old, have the smallest change of premium tax credit under the age based rules. Within my clients, people over 55 year old will get hit the hardest losing $200 to $400 per month in premium tax credit assistance.
Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
The formula for determining how much premium assistance, also known as the Affordable Care Act premium tax credits (PTC), to lower your monthly health bill is complicated. At its core the formula uses the inputs of your age, MAGI, a special contribution percentage and the annual cost of the Second Lowest Cost Silver Plan. Plugged into the formula, these inputs determine if any Advance Premium Tax Credits (APTC) will be awarded to reduce your health insurance premium. Some people are surprised to learn they don’t qualify for any APTC even though their MAGI is below 400% of the federal poverty level.
Covered California is cancelling the Advance Premium Tax Credit subsidy that lowers a household’s monthly health insurance premium for 2016 for some consumers. Through Covered California’s automatic renewal process I’ve seen several families’ tax credits disappear for 2016. Without intervention or explanation, many families who had their health insurance automatically renewed may receive a bill for the full premium amount because the tax credit subsidy was eliminated by Covered California.
One of the most frustrating aspects of the Affordable Care Act is that it excludes family members from receiving the premium tax credits to reduce their health insurance if one of the parents is offered affordable employer group health insurance. One way around this problem is for the employer to offer employee only coverage. Covered California for Small Business health insurance exchange offers the employee only option for employers when they set up their group health plans.
Information from a consumer’s 1095-A Marketplace Statement reveals that Covered California continued to credit Anthem Blue Cross with Advance Premium Tax Credits (APTC) even after the consumer had transitioned to Medi-Cal. While there doesn’t appear to be any fraud, Anthem did receive at least $647 for an individual who was no longer a member of their […]
The 1095-A Health Insurance Marketplace Statement doesn’t give a clue on how the Monthly Advance Payment of Premium Tax Credit is calculated. Even though consumers who purchased health insurance through the Marketplace entered their Modified Adjusted Gross Income (MAGI) into the enrollment system, this income in not listed on the 1095-A they receive. The MAGI […]
One of the common complaints during tax season for individuals and families who are set to receive a federal refund is that the government got to use their money for a year before refunding it to them. Now, households who have to repay excess ACA tax credits find themselves in the situation where they got to use a […]
Anyone who did not have health insurance for a period of more than three months during 2014 will have to pay a penalty on their IRS federal tax return. This penalty is also known as Affordable Care Act Shared Responsibility Payment. The ACA has given taxpayers who went without having health insurance for a period during […]