Affordable Care Act (ACA)
The Affordable Care Act (ACA) includes both tax-related and non-tax provisions for health care coverage and financial assistance options. The IRS administers the tax provisions of the law, while Health and Human Services (HHS) is the lead agency for the non-tax provisions.
Individuals and Families
If you get insurance coverage through the Health Insurance Marketplace, and not another source like your employer or a government sponsored plan, you may be eligible for a Premium Tax Credit to help you pay for that coverage.
Premium Tax Credit Change Estimator
Helps you estimate how your premium tax credit will change if your income or family size changes during the year.
Starting in January 2014, the Individual Shared Responsibility Provision requires you and each member of your family to have qualifying health care coverage (called minimum essential coverage) in each month of the year, qualify for an exemption from coverage, or make a shared responsibility payment when you file your federal income tax return.
Individual Shared Responsibility Provision Payment Estimator
Helps you estimate the amount you may have to pay if you did not have minimum essential coverage during the year.
Healthcare Information Forms
Because your health coverage can affect your taxes, you may receive informational forms from insurance providers – the Marketplace, your insurer, or your employer. For more information on these forms — who should expect to receive the forms, how they can be used, and how to file with or without the forms — see IRS.gov’s questions and answers and details on IRS Forms 1095-A, 1095-B, and 1095-C.
Please Note: The IRS has extended the due dates for furnishing to individuals the 2016 IRS Form 1095-B, Health Coverage, and the 2016 IRS Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, from January 31, 2017, to March 2, 2017.
Businesses and Employers
Important business/employer provisions describe the rules about benefits and responsibilities. The rules are generally segmented based on the size and structure of the workforce, so different rules apply to employers who are considered small, large, or part of a group.
The Small Business Health Care Tax Credit (SBHCTC) is available to some small employers who offer health insurance to their employees and pay at least half of their premiums. TAS offers SBHCTC Estimators for current and prior tax years to help small employers determine if they qualify for this credit and if so, for approximately how much.
Small Business Health Care Tax Credit Estimator
Find out if you might be eligible for the Small Business Health Care Tax Credit and how much you might receive.
A version of the estimator is also available for tax years 2010-2013.
Other Business Provisions
For 2015 and after, the Employer Shared Responsibility Provision (ESRP), requires employers with a certain number of employees to offer qualifying health insurance coverage or make a shared responsibility payment. (IRS has a webinar titled, ACA: Employer Shared Responsibility, which provides an overview of the provision requirements, as well as two others that provide details on information reporting. All are available 24/7 on the IRS Video Portal.)
Other organizations, such as insurers and exempt organizations, also have requirements under the ACA. More information about these groups is available on IRS.gov.
Employer Shared Responsibility Provision Estimator
Employers (for 2016 and forward), can use this tool to determine: the number of full-time employees (including FTEs); if your company might be an applicable large employer, and if you are, an estimate of the maximum amount of the potential payment that could apply, if you fail to offer required insurance coverage.
In addition to the IRS.gov ACA Information Center for Tax Professionals, you can use TAS’s ACA Estimators (listed above) with your clients though-out the year for planning purposes.
For legal references and official guidance, visit the IRS.gov ACA Legal Guidance and Other Resources Affordable Care Act Tax Provisions page.