This past year, the Affordable Care Act (ACA) has taken full effect with the implementation of Healthcare.gov and the public insurance exchange. The 2015 tax season is the first time that individuals and families will be required to report basic information regarding their health coverage on their tax return.
Effects on Healthcare Providers
Healthcare changes in 2015 will also affect physicians as they attempt to provide the highest quality healthcare at the lowest price for low-income individuals. Millions of newly insured Americans will be looking for a primary care physician and eventually specialists as well. The new health insurance exchange enrollees will be mostly low-income individuals who will receive subsidies to buy coverage and pay out-of-pocket charges.
The Center for Medicare/Medicaid Services (CMS) has introduced reductions in reimbursements for noncompliant physician practices. Physicians must comply with CMS’s new Value-Based Payment Modifier program, or face penalties. The Value-Based Modifier program calculates Medicare’s payments to physicians in group practices based on annual cost and quality measures.
Effects on Business
According to taxact.com, “in 2015, businesses with more than 50 full-time employees (or a combination of full-time and part-time employees equivalent to 50 full-time employees) employed in 2014 must either offer a minimum level of health care coverage to employees and their dependents, or pay the IRS Employer Shared Responsibility payments for any full-time employees who purchase coverage through a marketplace and receive the premium tax credit.”
As the ACA becomes standard businesses will certainly be looking to make significant changes to the type of plans and contributions they make available to their employees. Rather than public exchanges, businesses will most likely look to the private insurance marketplace as their means of compliance.
Another change in business’ approach to healthcare is to reduce the number of health risks in their employees by providing vouchers or discounts for mobile, wearable health products. Forbes predicts that 70-80 percent of large businesses will do this by the end of 2015.
Effects on Taxpayers
This IRS publication covers some of the tax provisions of the Affordable Care Act (ACA).
Most tax filers (75 percent) will just check a box on their tax return to indicate that they had coverage all year. These individuals meet the Minimum Essential Coverage requirement, the health coverage necessary to meet the Affordable Care Act’s requirement.
If tax filers don’t have health insurance for a total of 2 or more months in 2015, they may be subject to a penalty on their tax return due April 18, 2016. The penalty amount is based either on the number of uninsured individuals in your household ($325 per adult and $162.50 per uninsured dependent under the age of 18) or 2 percent of your 2015 household income – whichever is higher.
Uninsured individuals may want to file for exemption in order to avoid a penalty. Tax filers hoping to do so should go to www.healthcare.gov/exemptions to see if they qualify.
For your clients to avoid penalties, they should visit www.healthcare.gov to learn about their 2015 coverage options and to apply for coverage. Open enrollment is November 1, 2015 to January 31, 2016. Make sure they know they may even qualify for the advance premium tax credit.
For more information about changes accompanying healthcare legislation in 2015 sign up here for our webinar, Taking Your Medicine: Healthcare in 2015 (OBC4).