TaxVox What's Happened to the ACA Penalty Tax?
Roberton C. Williams
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With less than two weeks to go before Americans must file their 2016 federal income tax returns, those who didn’t have required health insurance coverage last year have a decision to make: Do they report their lack of coverage and pay a penalty or ignore the law and blow off the tax. And they must make their decision after the IRS announced it will accept returns if filers ignore their obligation to pay the penalty, but also warned that they still owe the extra tax.

Since 2014, the Affordable Care Act (ACA) has required taxpayers to check a box on their 1040 saying that they had insurance coverage throughout the year, file a separate form claiming an exemption from the coverage requirement, or pay a penalty tax, formally named the “shared responsibility payment.”

The penalty started small—the larger of $95 per family member or 1 percent of income in 2014—but ramped up sharply to the 2016 level of $695 per person or 2.5 percent of income, whichever is larger. The penalty is pro-rated for people who had coverage part of the year and is capped by the average cost of a basic health plan. The cap only affects high-income households—single individuals with 2016 income over about $107,000 and larger families with incomes that are multiples of that amount.

The Tax Policy Center’s handy penalty tax calculator shows how large the penalty would be for a household with the income and demographic characteristics you select.

Roughly 80 percent of non-dependent income tax returns filed for 2015 reported full-year health insurance coverage. Nearly 13 million returns (about 9 percent of non-dependent returns) claimed an exemption from the penalty because of low-income or for other reasons such as religious beliefs or unlawful presence in the US. About 6.5 million returns (5 percent) reported and paid an average penalty tax of $470, more than double the $210 average paid on 2014 returns. That leaves about 2 percent of returns that didn’t report full-year insurance coverage, claim an exemption, or pay the penalty tax.

In the run-up to the current 2016 tax filing season, the IRS said it would change practices from prior years and reject returns in that last group. But following President Trump’s January 20 executive order directing agencies to reduce potential burdens of the ACA, the IRS reversed course and said it would process returns, whether or not they met the ACA tax requirements. Makers of tax preparation software followed suit and said their programs would allow users to file returns that failed to comply with the ACA provisions.

But that doesn’t mean taxpayers are off the hook. The IRS also said that “legislative provisions of the ACA law are still in force until changed by the Congress, and taxpayers remain required to follow the law and pay what they may owe‎.” In other words, the IRS won’t make you report, but if you owe the penalty, you still must pay.

The real question is whether the IRS will actually enforce the penalty. The ACA limits the agency’s ability to collect the tax—it can only take payments out of tax refunds of people who don’t voluntarily comply. Organizations opposed to the ACA have advised people to skip insurance coverage and ignore the penalty tax, citing the limits on IRS enforcement.

If you didn’t have adequate health insurance last year and did not qualify for an exemption, you’ll have to decide whether to include the shared responsibility payment on your tax return or take a chance that you can get away without paying. It’s much safer to pay what you owe.

Tags Affordable Care Act tax penalty Affordable Care Act tax day IRS
Primary topic Individual Taxes
Research Area Health care