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Regulation and Compliance > Federal Regulation > IRS

IRS explains PPACA for plain folks

By Allison Bell

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The Internal Revenue Service (IRS) has posted drafts of two major new health law guides for taxpayers.

The guides are complicated enough to send some consumers who look at them straight to tax preparers. 

One, the Instructions for Form 8965, gives consumers the information they need to claim exemptions from the Patient Protection and Affordable Care Act (PPACA) individual coverage mandate.

The 12-page guide includes one large table, for example, that shows where individuals should go to get hardship exemptions or coverage exemptions. The table shows that a taxpayer must go to a state exchange to document that the taxpayer qualifies for a hardship exemption because the taxpayer has no access to affordable coverage. The table shows that a consumer can get a coverage exemption based on incarceration simply by indicating that on a tax return.

PPACA instructions

Another table shows what types of health coverage qualify as being the kinds of “minimum essential coverage” (MEC) that can get a taxpayer out of paying the penalty to be imposed on many people who fail to have MEC.

A second PPACA guide, the Instructions for Form 8962, tries to explain what consumers should do about PPACA premium tax credits.

PPACA provides for many exchange users to get tax credit subsidies they can use to pay for coverage while the tax year is still under way. Consumers who get too much help from the advance premium tax credit (APTC) are supposed to pay the excess APTC payments back to the government.

That guide includes a worksheet for computing the taxpayer’s modified adjusted gross income, a table for showing how a family’s income compares with the federal poverty limit, and a worksheet consumers can use to see whether marriage led to them receiving excess advance premium tax credits.

The IRS also has posted:

Notice 2014-55 — a notice that lets full-time workers in Section 125 cafeteria plans who have access to employer-sponsored major medical coverage and then end up becoming part-time workers get their coverage from a PPACA public exchange instead.

Notice 2014-56 — a notice that sets the “applicable amount” an employer must use to compute the Patient-Center Outcomes Research Institute (PCORI) fee for plan years ending on or after Oct. 1, 2014, at $2.08. The old PCORI amount was $2.

Notice 2014-49 — a notice that sets the rules for how an employer should treat an employee for employee counting purposes when the employee transfers from a position governed by one measurement period to a position governed by another measurement period.

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