Close Close
Sign In
Newsletters
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards
Podcast Center Video Center Webcasts Resource Center Events
About ThinkAdvisor Contact Us Advertise With Us Asset & Logo Licensing Sitemap Terms of Service Privacy Policy Copyright © 2024 ALM Global, LLC. All Rights Reserved.
ThinkAdvisor
Robert Bloink and William H. Byrnes

Financial Planning > Tax Planning > Tax Deductions

Will the Inflation Reduction Act Push Employers Away From Sponsoring Health Plans?

By Robert Bloink By William H. Byrnes

X
Your article was successfully shared with the contacts you provided.

What You Need to Know

  • The new law extends enhanced premium subsidies, making marketplace plans more attractive.
  • These subsidies can mean increased penalties for employers that are subject to the employer mandate.
  • Many employers may opt instead to fund newly available individual coverage health reimbursement arrangements.

As a surprise to some, the Inflation Reduction Act extended the enhanced Affordable Care Act premium subsidies through 2025 — meaning that it’s entirely possible that the new rules for claiming the premium tax credit could be made permanent.

While these subsidies are designed to ensure that millions of Americans have access to affordable health care, they can also create a headache in the form of increased penalties for employers that are subject to the employer mandate. 

On the other hand, they may make ACA marketplace health plans an even more attractive option — prompting many employers to back away from traditional employer-sponsored health coverage in favor of funding newly available individual coverage health reimbursement arrangements (ICHRAs) going forward.

Premium Tax Credit Subsidy Expansion

As the Affordable Care Act is written, taxpayers qualified for premium tax credit assistance only if their income was less than 400% of the federal poverty guidelines. Last year’s American Rescue Plan Act expanded the availability of premium tax credit subsidies by lifting that income cutoff so that taxpayers could be eligible if their required contribution to health insurance exceeded 8.5% of their household income. The 2022 Inflation Reduction Act extended these expanded subsidies through 2025. 

For 2023, even more taxpayers may qualify for the premium tax credit because the IRS recently announced that the affordability threshold will decrease significantly, to 9.12% for 2023. This decrease means that many employers will be required to pay more for employee coverage in 2023 because employer-sponsored coverage will be deemed affordable only if the employee’s required contribution for self-only coverage does not exceed 9.12% of the employee’s household income. 

Employers whose employees receive the premium tax credit because their employer-sponsored coverage is deemed unaffordable remain subject to steep penalties even after the individual mandate was eliminated. Because more taxpayers will be eligible for the premium tax credit, it’s possible that more employers will also become subject to penalties for failure to provide affordable coverage.

The ICHRA Solution

Under prior law, employers could not reimburse employees for individual health insurance premiums via the tax-preferred HRA structure because HRAs were deemed to fail certain prohibitions imposed by the ACA. In 2019, however, the Departments of Labor, Health and Human Services (HHS), and Treasury changed course to develop a new set of rules that expanded employer options for providing coverage via ICHRAs starting in 2020.

The rules now allow employers to reimburse premiums for individual health insurance coverage through ICHRAs if the several specific conditions are satisfied.

First, all individuals enrolled in the ICHRA must actually enroll in individual coverage. If an individual ceases to be enrolled in individual coverage, the ICHRA must stop reimbursing their medical expenses (on a prospective basis only). Individuals who are still within the grace period with respect to paying their premiums for individual coverage are considered enrolled in individual coverage. Employers are permitted to rely upon employee certification as long as they don’t have knowledge to the contrary.

The employer can’t offer the ICHRA coverage option to one class of employees if it offers group health coverage to others in the same class of employees. Further, the HRA must be offered on the same terms to members of employees within a given class of employees where consistent definitions are used to determine employee classifications.

Permissible classes of employees include part-time employees, full-time employees, seasonal workers, hourly workers, salaried workers, new hires and workers employed or not employed through a temporary staffing agency. In response to concerns that the expanded HRA option could allow employers to push sicker workers into the individual markets by manipulating the “class of employees” requirement, the agencies imposed strict limits on the class sizes in certain situations. 

While these restrictions may be detailed, there are no limits to the amount that the employer can reimburse under the ICHRA structure. Further, employers can choose whether to reimburse insurance premiums, only qualified medical expenses or both.

Going forward, the ICHRA option may result in some employers choosing to satisfy their ACA obligations through reimbursing employees for the cost of purchasing their own health insurance through the marketplace — rather than offering a traditional employer health plan.

Conclusion

The decreased affordability threshold and expanded ACA subsidies may put a strain on certain employers — and might even discourage those employers from offering traditional health coverage. The individual coverage HRA strategy can present a possible solution to employers who either must offer coverage or are interested in offering health benefits to attract and retain employees.

___________________

  • Learn more with Tax Facts, the go-to resource that answers critical tax questions with the latest tax developments. Online subscribers get access to exclusive e-newsletters.
  • Discover more resources on finance and taxes on the NU Resource Center.
  • Follow Tax Facts on LinkedIn and join the conversation on financial planning and targeted tax topics.
  • Get 10% off any Tax Facts product just for being a ThinkAdvisor reader! Complete the free trial form or call 859-692-2205 to learn more or get started today. 

Robert Bloink

William H. Byrnes

NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.