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ACA Individual Mandate Penalty No Longer Applies

ACA Individual Mandate Penalty No Longer Applies

OVERVIEW

On Dec. 22, 2017, President Donald Trump signed into law the tax reform bill, called the Tax Cuts and Jobs Act, after it passed both the U.S. Senate and the U.S. House of Representatives.

This tax reform bill makes significant changes to the federal tax code. The bill does not impact the majority of the Affordable Care Act (ACA) tax provisions. However, it does reduce the ACA’s individual shared responsibility (or individual mandate) penalty to zero, effective beginning in 2019.

As a result, beginning in 2019, individuals will no longer be penalized for failing to obtain acceptable health insurance coverage.

ACTION STEPS

‎The ACA’s individual mandate penalty no longer applies, beginning in 2019. However, individuals will still need to certify on their 2018 tax return (filed in early 2019) whether they complied with the individual mandate for 2018.

In addition, a failure to obtain acceptable health coverage for 2018 may still result in a penalty for the individual for that year on their 2018 tax return (filed in early 2019).

‎The Individual Mandate

The ACA’s individual mandate, which took effect in 2014, requires most individuals to obtain acceptable health insurance coverage for themselves and their family members or pay a penalty. The mandate is enforced each year on individual federal tax returns. Starting in 2015, individuals filing a tax return for the previous tax year indicate, by checking a box on their returns, which members of their family (including themselves) had health insurance coverage for the year (or qualified for an exemption from the individual mandate). Based on this information, the IRS then assesses a penalty for each nonexempt family member without coverage.

Effect of the Tax Reform Bill

The tax reform bill reduces the ACA’s individual mandate penalty to zero, effective beginning with the 2019 tax year. This effectively eliminates the individual mandate penalty for the 2019 tax year and beyond. As a result, beginning with the 2019 tax year, individuals will no longer be penalized for failing to obtain acceptable health insurance coverage for themselves and their family members.

Impact on Years Prior to 2019

Although the tax reform bill eliminates the ACA’s individual mandate penalty, this repeal did not take effect until 2019. As a result, individuals were still required to comply with the mandate (or pay a penalty) for 2018. This means that individuals must still certify on their 2018 tax return (filed in early 2019) whether they complied with the individual mandate for 2018. Therefore, taxpayers should indicate on their 2018 tax returns whether they (and everyone in their family):

  1. Had health coverage for the year;
  2. Qualified for an exemption from the individual mandate; or
  3. Will pay an individual mandate penalty.

In addition, a failure to obtain acceptable health coverage for 2018 may still result in a penalty for the individual for that year. Individuals who are liable for a penalty for failing to obtain acceptable health coverage in 2018 will be required to pay that penalty when they file their federal income taxes in 2019. As a result, some individuals may be required to pay the individual mandate penalty in early 2019, based on their noncompliance for the 2018 tax year.

Effect on Other ACA Provisions

Despite the repeal of the individual mandate penalty, employers and individuals must continue to comply with all other ACA provisions. The tax reform bill does not impact any other ACA provisions, including the Cadillac tax on high-cost group health coverage, the PCORI fees and the health insurance providers fee. In addition, the employer shared responsibility (pay or play) rules and related Section 6055 and Section 6056 reporting requirements are still in place.

 

 

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