Tara StrawHealth Action 2012  January 19, 2012
     Do you know what    your tax credit is?
Recalculate the creditConsider: ◦ Your family (& your tax family & your coverage   family) ◦ Income (all sources) ◦ Other ...
   The credit for 2014 was calculated based on    your 2012 tax return.   Since then …    ◦   Your   marital status has ...
   Taxpayers who marry during the year    ◦ Problem: 1+ 1 = 3    ◦ Recommendation: Account for lower incomes while      p...
   Changes in family composition   People on your insurance, but not on your    taxes   People on your taxes, but not o...
   What to report   When to report   Who to report toMid-year job loss  Subsidy may be too lowMid-year job gain Subs...
   More types of coverage = more complications    ◦   Did the Exchange get it right?    ◦   Did I get it right?    ◦   Tr...
Repayment or additional credit (up tobenchmark premium)          Income           Maximum                          Repayme...
Vanessa is married… but separatedfrom her husband.She has 3 children.She has wages of$31k, but sellscosmetics on theside, ...
   Medicaid eligibility    ◦ $33,400 for a family of 4 is 143% FPL    ◦ Kids look to be Medicaid or CHIP eligible   Mari...
   Change the employer affordability test   Ease family transitions   Mandate the use of forms that simplify    consume...
   Clear rules and uniformity on reporting    ◦ Exchange duties:      Makes advance credit determination*      Collect ...
   Identify    ◦ Who is eligible for credits?    ◦ Who will find them?   Simplify    ◦ Don’t require people to remember/...
Making The Premium Tax Credits Work
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Making The Premium Tax Credits Work

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Making The Premium Tax Credits Work

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Making The Premium Tax Credits Work

  1. 1. Tara StrawHealth Action 2012 January 19, 2012
  2. 2.   Do you know what your tax credit is?
  3. 3. Recalculate the creditConsider: ◦ Your family (& your tax family & your coverage family) ◦ Income (all sources) ◦ Other sources of coverage ◦ Your benchmark premium ◦ Your advance credit
  4. 4.  The credit for 2014 was calculated based on your 2012 tax return. Since then … ◦ Your marital status has changed ◦ Your family has changed ◦ Your job has changed ◦ Your insurance coverage has changed
  5. 5.  Taxpayers who marry during the year ◦ Problem: 1+ 1 = 3 ◦ Recommendation: Account for lower incomes while people are single. Taxpayers who divorce Taxpayers who are separated ◦ Problem: No tax credit if you file separately from your spouse! ◦ Recommendation: Exceptions for abandoned spouses, domestic abuse, and other circumstances.
  6. 6.  Changes in family composition People on your insurance, but not on your taxes People on your taxes, but not on your insurance * May not reflect your actual family.
  7. 7.  What to report When to report Who to report toMid-year job loss  Subsidy may be too lowMid-year job gain Subsidy may be high
  8. 8.  More types of coverage = more complications ◦ Did the Exchange get it right? ◦ Did I get it right? ◦ Trapped between Medicaid and the Exchange? ◦ Premium stacking Is your employer-sponsored coverage affordable?
  9. 9. Repayment or additional credit (up tobenchmark premium) Income Maximum Repayment (Single/Family) <200% FPL $300/$600 200%-300% FPL $750/$1,500 300%-400% FPL $1,250/$2,500 >400% FPL No Cap
  10. 10. Vanessa is married… but separatedfrom her husband.She has 3 children.She has wages of$31k, but sellscosmetics on theside, earning anadditional $2,400. 10
  11. 11.  Medicaid eligibility ◦ $33,400 for a family of 4 is 143% FPL ◦ Kids look to be Medicaid or CHIP eligible Marital status ◦ Is she eligible for credits or excluded by filing separately from her husband? Benchmark ◦ Second-lowest cost silver self-only plan (~$4,300) Vanessa’s share of premium is 3.6% ($155/yr) ◦ Vanessa’s credit is $4,142
  12. 12.  Change the employer affordability test Ease family transitions Mandate the use of forms that simplify consumer decisionmaking and end-of-year reconciliation Prepare for comprehensive training of enrollment staff and volunteers
  13. 13.  Clear rules and uniformity on reporting ◦ Exchange duties:  Makes advance credit determination*  Collect names and employer ID of each employer with one or more employees determined eligible for the tax credit  Determination that employer did not provide minimum essential coverage, plan didn’t meet 60% AV, or plan was unaffordable
  14. 14.  Identify ◦ Who is eligible for credits? ◦ Who will find them? Simplify ◦ Don’t require people to remember/calculate/estimate – Tell them what they need to know! Demystify ◦ Customer service ◦ No black box on information ◦ Make sure consumers have tools to make educated decisions in exchange and ESI ◦ Give consumers tools to understand reconciliation
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