Affordable Care Act

The Affordable Care Act Tax Provisions for Individuals and Families

THE BASICS

As of 2014, all individuals are now required to have health insurance coverage OR to qualify for an exemption from this requirement. These requirements apply to everyone on YOUR tax return – you, your spouse, your children, and anyone else that you can claim as a dependent on your tax return. New in 2019: the SHARED RESPONSIBILITY PAYMENT (or, penalty for not having health insurance), has been reduced to ZERO, so you will not incur any additional penalty or tax for not having health insurance coverage on 2019 or later returns.

All individuals who had health insurance will receive a form 1095 A, B or C. These forms report information on your coverage and will be required to complete your tax return this year.

IRS will not accept returns without the insurance info.

HEALTH COVERAGE

Health coverage that you received through an employer, a policy you purchased on your own (either directly or through a state or federal health insurance exchange), Medicare, Medicaid, or Oregon Health Plan will generally meet the requirements for coverage. See a comprehensive list here.

PREMIUM TAX CREDIT

You may qualify for a refundable tax credit to help offset the costs of health coverage. This credit is ONLY available to you if you purchased your policy through a state or federal exchange, and your adjusted household income is less than 400% of the Federal Poverty Level. See here for more details on qualification, including the income tables (for information only – this is calculated as part of your tax return automatically).

Some taxpayers were given the ability to get this credit in advance, which reduced the amount you had to pay each month for your insurance. If this is the case, your tax return is where we compare the tax credit that you actually got to the tax credit you qualify for. If you chose not to take the advanced credit, or if you actually qualify for more than you received, the additional credit will be refunded to you on your tax return. However, if you got more money advanced to you than you qualify for, you may be required to pay back some of the advanced credit you received. Again, this will be automatically calculated as part of your return when we prepare your taxes.

If you purchased your insurance through The Marketplace, you will receive a FORM 1095-A. We must have this form to prepare your taxes.

ADDITIONAL INFORMATION

The IRS has released written guidance on this in Publication 5187, available for you to download here. They also have an overview page for Affordable Care Act provisions here.

Go to The Marketplace to apply for coverage, report life changes, apply for a penalty exemption, or browse FAQs.