Kansas State University


Issues in Health Reform

Month: February 2015

Who gets tax subsidies to pay for health insurance anyway?

As the Supreme Court is set next week to hear King v Burwell, the case against tax subsidies’ eligibility for non state Exchange state purchasers of health insurance, earlier post, this essay points out how most of us receive subsidies to pay for health insurance..whether it’s the Medicare population who paid into the system no where near what they are taking out, or those of us whose employers get our insurance premiums as a business write-off, and we get the benefit as pre-tax income.  As Rampell points out, these facts are important to understand in the face of the resistance many have to the tax subsidies received by most of the folks who purchase insurance through the Marketplace Exchanges.  The tax subsidies for those who work but don’t have employer sponsored insurance levels the playing field.   http://www.washingtonpost.com/opinions/if-you-want-to-know-who-gets-health-care-handouts-look-in-the-mirror/2015/02/26/53e2de84-bdf9-11e4-bdfa-b8e8f594e6ee_story.html?wpisrc=nl_opinions&wpmm=1

Enrollment in Kansas Marketplace

Open Enrollment in the Health Insurance Marketplace is officially closed for most.  Nationally the numbers show that over 11 million Americans signed up, either for the first time or with a renewal of their last year’s insurance plans.   http://www.hhs.gov/healthcare/facts/blog/2015/02/open-enrollment-week-thirteen.html

The number of Kansans enrolled in 2015 is 96,226, almost double the 57,000 from 2014.   That is just under the 100,000 likely eligible to enroll in Marketplace as estimated here:  http://kff.org/health-reform/state-indicator/state-marketplace-statistics-2014/

Early estimates continue to report over 80% of those enrolled being eligible for assistance in paying for premiums, with a subset of those also eligible for cost sharing assistance for out of pocket expenses.


Tax Implications for ACA: How to Avoid Tax Penalty for 2015

While the general Open Enrollment in the Marketplace ended February 15, the IRS has announced a new Open Enrollment period between March 15 – April 30, 2015.  It is only for those who discover that they will be paying a penalty with their 2014 taxes because they do not have health insurance, AND who can claim that they did not understand the consequences of not being insured impacting their taxes.  This will not impact their penalties for 2014 if they were uninsured in 2014 for but allow folks to avoid the penalty for their 2015 tax year. See this CMS news release for the full details: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-02-20.html

Consumers seeking to take advantage of the special enrollment period can find out if they are eligible by visiting https://www.healthcare.gov/get-coverage Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Assistance is available in 150 languages. The call is free.

This year 2014 that penalty is 1% of annual income above the tax filing threshold (or $95, which is GREATER).  And next year the penalty goes up to 2%.  So, remaining uninsured is not only a financial risk for health reasons, it costs money upfront.  Of course, it also makes sense to have good coverage especially since that now has to include preventive care at no upfront cost and no one can be excluded because of health reasons.