ObamaCare & Taxes: How Life Changes Can Impact Your Premium Tax Credit - National Women's Law Center (2024)

  1. What kind of life changes could potentially impact my Premium Tax Credit?

The amount of your Premium Tax Credit is based on both the number of people in your household and your household income. Events that change your household size or income can change the amount of your Premium Tax Credit. Some examples of these types of changes include:

  • Giving birth
  • Adopting a child
  • Marriage
  • Divorce
  • A new job
  • Loss of a job

If you have any of these changes or any other change in household income or size at any point during the year, you need to update the Marketplace with that information as soon as possible, so that your Premium Tax Credit can be adjusted.

If your income goes down or your household size goes up during the year, you may be eligible for an increase in your Premium Tax Credit. If your income goes up or your household size goes down, you should report it so that your Premium Tax Credit amount can be lowered, limiting how much you may owe back when you file your taxes.

Life changes may also affect your eligibility for the Premium Tax Credit. If you become eligible for other health insurance, you are likely no longer eligible for the Premium Tax Credit. Eligibility for the Premium Tax Credit is based in part upon your ineligibility for other “minimum essential coverage”—including Medicare, Medicaid, or employer-sponsored health insurance that is considered adequate and affordable. For example, a new job may bring an offer of health insurance through your employer, making you ineligible for the Premium Tax Credit. If you become pregnant, you may become newly eligible for Medicaid during the pregnancy and postnatal period. So if at some point during the year, you receive an offer of health insurance through your employer, or you find out that you qualify for Medicaid or Medicare, you should update the Marketplace.

  1. If I have a change in household size or household income, when and how do I let the Marketplace know?

You should contact the Marketplace as soon as possible when your income or household size changes—including both increases and decreases. This way, your Premium Tax Credit amount can be adjusted to match your actual circ*mstances, and you can avoid either having to repay some of the credit you received, or missing out on a larger Premium Tax Credit to help you pay for health insurance throughout the year.

You will also likely qualify for a special enrollment period to adjust other aspects of your health insurance (but act quickly, because you only have 60 days from the date your income or household size changed to adjust your plan).

Visit https://www.healthcare.gov/how-do-i-report-life-changes-to-the-marketplace/ or call 1-800-318-2596 to report your changes to family status, employment, or income, and adjust your Premium Tax Credit today.

  1. What should I expect when I file my tax return in 2017?

If you received a Premium Tax Credit in 2016, you will report that on the tax return that you file in 2017. The health insurance Marketplace will send you a form with the amount of Premium Tax Credit you received during the year. The Marketplace will also provide information regarding your Premium Tax Credit to the IRS. When completing your tax return, you will use form 8962 to compare the total Premium Tax Credit you received to a final calculation based on your actual 2016 income (what you actually made) and household size.

How will this impact you? You could receive a tax refund (or if you owe taxes, have the amount that you owe reduced)—but you could end up paying back part of the Premium Tax Credit the Marketplace paid to your health insurer throughout 2016. This is why it is so important to update the Marketplace with any changes in income or household size that occur through the year— don’t wait until tax time!

  1. Do I have to do anything in particular when I file my tax return in 2017, if I received the Premium Tax Credit in 2016?

You will need to fill out a form 8962 to send with your tax return (the IRS is writing it as we speak). The Marketplace will send you an information statement on the Premium Tax Credit you receive in 2016 by January 31, 2017, which you will use to fill out your tax return and any related IRS forms.

In most cases, married couples who receive a Premium Tax Credit in 2016 are required to file a joint tax return, unless they are either legally separated OR meet very narrow requirements in order to file as Head of Household (lived apart from a spouse for the last 6 months of the year and paid half of the costs to maintain a household where a dependent child lives for over half the year). There is an exception for victims of domestic violence and spousal abandonment, when filing a joint return is impossible or dangerous.

ObamaCare & Taxes: How Life Changes Can Impact Your Premium Tax Credit - National Women's Law Center (2024)

FAQs

How does Obamacare affect your taxes? ›

A tax credit you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace®. Your tax credit is based on the income estimate and household information you put on your Marketplace application.

What changes could affect the amount of premium tax credit? ›

Changes in circ*mstances that can affect the amount of your actual Premium Tax Credit include: Increases or decreases in your household income. Events that could result in a significant increase to household income include: Lump sum payments of Social Security benefits, including Social Security Disability Insurance.

What disqualifies you from the premium tax credit? ›

To be eligible for the premium tax credit, your household income must be at least 100 percent and, for years other than 2021 and 2022, no more than 400 percent of the federal poverty line for your family size, although there are two exceptions for individuals with household income below 100 percent of the applicable ...

Why is the IRS asking me for form 8962? ›

You must file Form 8962 to compute and take the PTC on your tax return. Advance payment of the premium tax credit (APTC). APTC is a payment during the year to your insurance provider that pays for part or all of the premiums for a qualified health plan covering you or an individual in your tax family.

What are the negative effects of Obamacare? ›

Cons:
  • The cost has not decreased for everyone. Those who do not qualify for subsidies may find marketplace health insurance plans unaffordable. ...
  • Loss of company-sponsored health plans. ...
  • Tax penalties. ...
  • Shrinking networks. ...
  • Shopping for coverage can be complicated.
Sep 29, 2021

How much did taxes go up because of Obamacare? ›

Full List of Obamacare Tax Hikes
First $200,000 ($250,000 Married) Employer/EmployeeAll Remaining Wages Employer/Employee
Current Law1.45%/1.45% 2.9% self-employed1.45%/1.45% 2.9% self-employed
Obamacare Tax Hike1.45%/1.45% 2.9% self-employed1.45%/2.35% 3.8% self-employed

What happens to Obamacare after 2025? ›

If the Inflation Reduction Act's enhanced subsidies expire, the vast majority of ACA Marketplace enrollees will see their premium payments increase significantly in 2026. The results of the 2024 elections will likely play a major role in whether enhanced subsidies are extended beyond 2025.

How to avoid premium tax credit repayment? ›

The easiest way to avoid having to repay a credit is to update the marketplace when you have any life changes. Life changes influence your estimated household income, your family size, and your credit amount. So, the sooner you can update the marketplace, the better. This ensures you receive the correct amount.

What is the highest income to qualify for Obamacare? ›

Who is eligible for health insurance subsidies? In 2024, you'll typically be eligible for ACA subsidies if you earn between $14,580 and $58,320 as an individual. For a family of four, you're eligible with a household income between $30,000 and $120,000.

What happens if I underestimate my income for Obamacare in 2024? ›

If you underestimated your income for that year and received a subsidy, you will need to pay the entire subsidy back the next time you file your taxes. You must report income changes to Covered California within 30 days. Note that you'll need to report income changes to Medi-Cal within 10 days.

What happens if my income increases while on Obamacare? ›

If your income goes up or your household size goes down, you should report it so that your Premium Tax Credit amount can be lowered, limiting how much you may owe back when you file your taxes.

Will I get penalized if I overestimate my income for Obamacare? ›

There's no penalty for overestimating or underestimating your subsidy; any discrepancy will be adjusted in your tax refund or payment. The IRS reconciles subsidies using Form 8962, and issues may arise if your income falls outside the 100%-400% federal poverty level range.

Why are my taxes rejected due to form 8962? ›

WASHINGTON — The Internal Revenue Service reminds taxpayers that an electronically filed tax return will be rejected if the taxpayer is required to reconcile advance payments of the premium tax credit (APTC) on Form 8962, Premium Tax Credit (PTC), but does not complete the form in the software and submit it with their ...

What happens if I don't fill out form 8962? ›

In general, it is very important to file your federal tax return with Form 8962 for any year you received an advanced premium tax credit. If you don't file Form 8962, the IRS will call this a failure to reconcile, and you could be prevented from applying for Marketplace premium tax credits in the future.

How does the premium tax credit affect my tax return? ›

If you use more advance payments of the tax credit than you qualify for based on your final yearly income, you must repay the difference when you file your federal income tax return. If you use less premium tax credit than you qualify for, you'll get the difference as a refundable credit when you file your taxes.

Do I have to pay back Obamacare tax credit? ›

If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.

Are my Obamacare premiums tax deductible? ›

It's an adjustment to your taxable income. When you have medical insurance through the ACA marketplace, you use pre-tax dollars to pay the premiums. As a result, anyone who has ACA coverage can deduct the full cost of their annual health insurance premium on their taxable income, using Form 1040.

Does paying health insurance affect your tax return? ›

Whether you get financial help or not, health coverage is part of filing your taxes. Unless you report that you had health coverage, you may have to pay a state tax penalty. If you received federal or state financial help, you'll report that as well.

How does Form 1095-A affect my taxes? ›

You will use the information from the Form 1095-A to calculate the amount of your premium tax credit. You will also use this form to reconcile advance payments of the premium tax credit made on your behalf with the premium tax credit you are claiming on your tax return.

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