Tara Straw March 4, 2013

 What to think about in 2013: ◦ Accurate and complete information ◦ Filing requirement ◦ Filing status ◦ Confronting expectations and preferences  What to think about in 2014: ◦ Staying up-to-date on changes in income and family  What to think about in 2015: ◦ Dependents ◦ Reconciliation or penalty

 Premium credits help pay for health plans  People can receive the credits in advance but might need to pay back excess at year end  Some plans (‘silver’ level plans) have lower cost- sharing for people with incomes up to 250% of poverty

 Must have income between % FPL  Cannot have minimum essential coverage ◦ Does job-based plan cost more than 9.5% of household income for single coverage? ◦ Does it meet minimum value?  Cannot be eligible for public coverage  Must have a valid SSN

 Must plan to file taxes ◦ People with previous unpaid taxes may be deterred  Must file jointly if married ◦ Rules to come re abuse/abandonment  Advance credits are based on projected annual income ◦ Reconciliation

Is it …  The most accurate amount of tax credit today?  The most accurate amount of tax credit based on estimates for the entire year?  The highest amount of credit?  The credit with the lowest risk of repayment? And will client, assistor/navigator, and tax preparer all agree?

 The starting point on premium credit eligibility are the tax returns being filed right now (2012 income)  What has changed between now and open enrollment? And what will change again by December 2014?  Initial application burden ◦ Special case: People without a valid social security number

 Should I take less assistance in advance?  What plan should I select, considering benefits, premiums, and cost sharing assistance?  What if only some members of my family need coverage?  What if electronic data not available or doesn’t match? -Medicaid, CHIP, Basic Health, Premium Tax Credit disputes

 Anticipate incomplete information on: ◦ Employer offer of coverage & cost of coverage  Inconsistencies? ◦ Income  Cash income  Wages from multiple part-time/part-year jobs ◦ Knowledge of who in the family currently has coverage and how ◦ Presence/absence of wellness incentives  How accessible will information be?

 Filing Requirements: ◦ Single - $9,750 (~87% FPL) ◦ Married Filing Jointly (with no kids) - $19,500 (~129% FPL) ◦ Head of Household (with two kids) - $12,500 (~65% FPL)  Generally, people below filing requirement will be Medicaid eligible (in expansion states)  Who might fail to file? ◦ IRS (or other) collectible debt ◦ Good news: advanceable premium tax credit won’t be used to offset debt

 Joint filing requirement  No credit if married filing separately ◦ Similar to EITC and other credits ◦ Prospective/retrospective problem ◦ Marriage/divorce counselor ◦ How does someone change the presumption?  Exceptions for … ◦ Survivors of domestic violence? (And others?) ◦ When? ◦ How?

 Reluctance ◦ Perceived value of coverage  Skepticism ◦ What’s the catch?  Gaming ◦ Due diligence  Advanced credit, lump sum or something else? ◦ Lump sum won’t be a viable option for most ◦ Fixed penalty vs risk of repayment

 Learning from the EITC  Barriers toward use of advanceable credits ◦ Lack of awareness ◦ Uncertainty ◦ Desire for a large refund ◦ Perceived inability to save  Premium tax credits can be different because: ◦ Infrastructure for accessing them ◦ Penalties for failure to obtain coverage ◦ Inability to collect large refund without incurring large costs

 Who, what, when of reporting income & family changes, including filing status ◦ Avoid large obligations at the end of the tax year ◦ Affects cost-sharing meanwhile ◦ Duty to counsel on this but it may be a deterrent  Changes in the offer of affordable job-based insurance  Due diligence with the “silent” exchange ◦ Can I trust the Exchange and my insurance company to make timely and accurate changes based on my information?

 Loss of coverage  Gain dependent  Change in immigration status  Gain eligibility for tax credit  Move  QHP violates contract with respect to enrollee  Error (sometimes)  Exchange-provided exception

 Filing Status ◦ If Married Filing Separately – exceptions?  Potential effects on dependency exemptions ◦ Dependents who are not your school-aged children ◦ “Qualifying relative”  Older kids, other relatives, members of your household who are not related to you  To claim exemption, must provide more than ½ of person’s support, including health care.  Support by the government is not support the taxpayer is providing

 Reconciliation  Re-enrollment: Was it worth it? IncomeMaximum Repayment (Single/Family) <200% FPL$300/$ %-300% FPL$750/$1, %-400% FPL$1,250/$2,500 >400% FPLNo Cap

 Penalty the greater of a flat dollar amount or a percentage of taxable income. ◦ 2014: $95/adult or 1% of taxable income  Exemptions if: ◦ No “affordable” coverage (in 2014, costs >8%) ◦ Income below the tax filing requirement ◦ Uninsured < 3 months ◦ Undocumented immigrants ◦ Hardship ◦ Incarcerated ◦ Membership in certain religious sects  Motivation or anger?

 Volunteer Income Tax Assistance (VITA) ◦ Free tax assistance for people with income below $51,000  Tax Counseling for the Elderly (TCE) ◦ Free tax assistance for people age 60 and older  Visit irs.gov for a list of programs in your community

 Develop local partnerships ◦ Work with tax partners and others ◦ Comprehensive public education ◦ Comprehensive training of enrollment staff and volunteers  Prepare for the unexpected  Expect the unprepared ◦ This is a multi-year effort!