Say Goodbye to the Tax Penalty for Not Having Health Insurance

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The Affordable Care Act, also known as the ACA and Obamacare, included a provision that taxed most Americans who didn’t buy and keep in place a specific type of health insurance. The reasoning behind the tax was the expectation that if EVERYONE were insured, rates would go down.

Not everyone agreed with this perspective and litigation was filed against the federal government. The Supreme Court ruling a few years later declared the Individual Mandate, the provision requiring the tax, constitutional because Congress has the power to impose taxes on Americans.

Unfortunately, everyone didn’t buy insurance after the ACA and its tax penalty became law, and the rates didn’t go down, either. In fact, in many cases they went up. And kept going up. The ACA was revised in 2017 and the tax penalty was reduced to zero effective 2019.

This was good news to all the people who chose not to buy insurance, but opponents of the ACA filed more litigation to have the entire law declared unconstitutional. The end result of that legislation brought about a ruling by the Fifth Circuit Court of Appeals last December. The Court ruled that if the Individual Mandate no longer contained a tax, it was unconstitutional. Essentially, if a tax is $0, it can’t be billed, collected, or enforced–so it isn’t real. Sort of like the tree falling in the woods and no one hearing it.

Anyway, what this means is that your clients who didn’t have health insurance last year, won’t be paying a tax penalty when they file they federal income tax returns ins April. However, if they live in one of the six U.S. jurisdictions that has its own Individual Mandate at the state level, they might still be taxed on their state returns if they didn’t have state-mandated coverage. Those 6 jurisdicitons are California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont.

Right now, opponents of the ACA who want the entire law declared unconstitutional are in the process of reviewing all the ACA’s provisions before bringing their case back to the District Court. It’s expected that the District Court will take some time considering and will eventually strike that down.

Update: Health Insurance and the Individual Mandate

When the Affordable Care Act (i.e., the ACA or ObamaCare) was originally enacted in 2010, a number of lawsuits were filed contesting its constitutionality. Many people were opposed to the federal government stipulating that most Americans had to be covered by a specific form of health insurance or be fined. (The ACA also required large employers to offer a specific form of health insurance to a certain percentage of full-time employees or be fined.)

The Individual Mandate is the ACA provision requiring individuals to be covered by health insurance that meets specific requirements of federal law to avoid paying a penalty. Technically, the monetary penalty was ruled a tax imposed by Congress and, therefore, the Individual Mandate was deemed constitutional by the Supreme Court.

In 2017, the Tax Cuts and Jobs Act reduced the Individual Mandate’s tax penalty to $0. This meant that beginning January 1, 2019, Americans were no longer taxed if they were not covered by federally mandated health insurance. As one would expect, that law also spurred litigation.

Last month, a federal Appeals Court ruled that because the Individual Mandate’s tax penalty was reduced to $0, it could no longer be considered a tax based on the criteria established by the Supreme Court in earlier legislation. Since the Individual Mandate no longer contains a tax, it is no longer constitutional.

While this decision might seem to indicate that everyone’s health insurance options will change this year, that is not the case. Why? Because another portion of the lawsuit heard by the Appeals Court was deferred until the lower court can study all the provisions in the ACA to determine which of them Congress intended to be severable from the rest of the ACA. In other words, just because the Individual Mandate is unconstitutional doesn’t mean all provisions of the ACA are, as well.

A complete review of the entire ACA will take months and months of time. Then, when the lower court submits its study to the Appeals Court, the ensuing judicial process can also be expected to take months. For the time being, our health insurance options should remain pretty stable, with the additional options offered by other recent federal legislation: the availability of Short-term Limited Duration Insurance (STLDI) and high-benefit, low-deductible health insurance plans (i.e., Cadillac plans). Note: the 40% tax on Cadillac plans was permanently repealed effective January 1, 2020 under the Further Consolidated Appropriations Act of 2020 (H.R. 1865).

Stay tuned for more info as it becomes available…