back to indexRPF0403-How_to_Avoid_the_Obamacare_Tax_Penalty
00:00:00.000 |
Welcome to Radical Personal Finance, the show dedicated to providing you with the knowledge, 00:00:04.600 |
skills, insight, and encouragement you need to live a rich and meaningful life now while 00:00:09.600 |
building a plan for financial freedom in 10 years or less. 00:00:14.560 |
Today we continue our discussion on health insurance generally with a specific focus 00:00:24.800 |
I've been needing to get this out for a couple of weeks here and here and as I record this 00:00:29.760 |
and release this on December 6, 2016, we've got just a little bit of about a month left 00:00:34.720 |
before open enrollment ends for the healthcare exchanges. 00:00:38.720 |
And so I obviously got to get this information to you if it's going to be useful. 00:00:43.760 |
So we're going to be doing a lot of health insurance this week and if there's anything 00:00:51.800 |
I'm going to talk through the Obamacare penalty. 00:00:55.400 |
I want to explain to you what it is, do some actual calculations so that you know how it 00:01:03.920 |
Next I want to talk about what happens if you don't pay the penalty. 00:01:09.280 |
And number three, I want to talk to you about how to get out of paying the penalty. 00:01:19.440 |
Before we get to that, a couple of quick announcements and one ad for you. 00:01:23.640 |
On announcement number one, as I mentioned on a recent show, I've opened up the Radical 00:01:29.040 |
Personal Finance Facebook group to the community in general. 00:01:32.120 |
I've had a couple of hundred of you who have gone ahead and joined us there and in the 00:01:38.720 |
It was previously limited only to patrons of the show. 00:01:42.040 |
At this point in time, it's now broadly available. 00:01:44.320 |
So if you are a Facebooker and you've got questions or you'd like to interact with a 00:01:48.160 |
very smart, very knowledgeable community of people, head on over to Facebook, search for 00:01:52.520 |
Radical Personal Finance, and you will find the community Facebook group. 00:01:58.880 |
Number two, big focus for this year, December here as we go into the year, I would really 00:02:04.520 |
desperately like very much to raise the number of reviews for Radical Personal Finance with 00:02:09.600 |
a specific focus on iTunes, but also some of the other platforms. 00:02:13.400 |
My target goal is to get to a thousand here within the next couple of months, and we're 00:02:17.400 |
currently at about 333, actually not about, exactly 333. 00:02:23.680 |
There are about 10,000 of you who listen every day on iOS devices. 00:02:27.780 |
If you have an iPhone, if you could do me one quick favor, when you're at a traffic 00:02:30.760 |
light, if you're listening to me while you're driving down the road, just pull open the 00:02:35.520 |
It's the app that's automatically installed on your phone. 00:02:40.060 |
Use the search function, search podcast, and you'll find it, or it's purple and it says 00:02:45.160 |
Use the Apple Podcast app and search for Radical Personal Finance in the store and just click 00:02:51.140 |
You can just simply leave a quick star rating for the show and one or two sentences on your 00:02:57.860 |
It's largely about, at this point in time, as far as helping the show grow and attain 00:03:02.040 |
visibility, the number of reviews is quite valuable and quite helpful. 00:03:09.680 |
My target goal is to raise that number to a thousand here within the next month or two. 00:03:13.680 |
So if you could help me with that, I would be deeply indebted to you. 00:03:18.060 |
One or two sentences is perfect and it'll just take about two or three minutes right 00:03:24.120 |
Finally, quick announcement here in December, quick ad. 00:03:28.560 |
I do phone consulting and I haven't made a big press on this, but I'm going to be doing 00:03:33.040 |
a lot more press as far as announcements and advertisements and things for you. 00:03:37.460 |
But I have been doing phone consulting with listeners of the audience. 00:03:40.280 |
At this point in time, I've been doing about 50 individual private phone calls. 00:03:44.640 |
If you've ever thought about talking to me, if you hear some of the ideas and the things 00:03:50.200 |
that I share and you'd like to get some specific advice on your specific situation, I encourage 00:03:54.920 |
you to consider booking a phone call with me. 00:03:56.760 |
Let me read you a couple of reviews from some of the phone calls that I have done. 00:04:01.320 |
You can find these on the Clarity profile, which you go to radicalpersonalfinance.com/phonecall. 00:04:06.200 |
That forwards you through to the profile where you can book a phone call with me. 00:04:13.400 |
"We had a very informative conversation with Joshua Sheets. 00:04:16.160 |
We wanted help selecting a financial advisor for our family and he was very knowledgeable 00:04:21.000 |
He both expanded our thinking while at the same time helped us get focused on a decision." 00:04:27.720 |
Once again, Joshua Sheets delivers tremendous value." 00:04:29.680 |
By the way, these are all paid calls, not free calls or any gimmicks like that. 00:04:35.080 |
"BS, Joshua was well prepared and the call was a great use of my time and money. 00:04:39.400 |
I left the call feeling more confident as I go forward with my upcoming financial decision." 00:04:44.200 |
"The opportunity to speak with Joshua personally was a valuable opportunity in itself, but 00:04:47.760 |
our conversation yielded several useful takeaways. 00:04:51.600 |
This is the kick in the pants I was looking for." 00:04:53.400 |
Finally, "Joshua is a very organized way when it comes to thinking about financial 00:05:00.160 |
He helped me finalize my decisions through this call." 00:05:02.640 |
So a lot of your fellow listeners have booked consulting calls with me and have found a 00:05:08.680 |
If you're struggling with a specific decision, let me tell you this. 00:05:12.120 |
Financial advice is not cheap when you measure it on a per minute basis. 00:05:16.080 |
My hourly rate here is 300 bucks an hour, so that comes out to $5 a minute. 00:05:21.720 |
That advice is not cheap when measured on an hourly basis. 00:05:24.640 |
That's just basically a standard professional rate. 00:05:28.940 |
But in terms of the impact, I don't believe there's any better bang for the buck that 00:05:34.200 |
you can get than good, useful, practical financial advice. 00:05:40.660 |
So if you've ever wanted my input on a specific situation with you, I get a hopeless number 00:05:45.140 |
of emails that I can't respond to at this point in time. 00:05:48.520 |
As I've opened up the Facebook community, there's a hopeless number of posts in there 00:05:52.520 |
that I try to read and get a grasp of what's going on, but I can't respond to there. 00:05:56.520 |
But money speaks, and I am presently offering this consulting call service. 00:06:01.000 |
As we're here in December 2016, heading into a new year, if you are thinking about 00:06:04.820 |
your financial goals for the next year, if you'd like some help organizing your thoughts 00:06:08.440 |
and organizing your ideas on that, consider booking a phone call with me, RadicalPersonalFinance.com/phonecall. 00:06:24.220 |
So thing number one, what is the Obamacare penalty? 00:06:28.400 |
So to refresh, meaning, okay, we get that there's a penalty if you don't have health 00:06:31.680 |
insurance, but we want to talk about how is it calculated. 00:06:35.660 |
To refresh your memory, it's important to recognize that given the nature of health 00:06:41.120 |
insurance, recognizing that the legislative intent of the Affordable Care Act was to open 00:06:50.400 |
up health insurance to every person in the United States. 00:06:55.120 |
That was the goal, make health insurance available to every person in the United States. 00:07:00.520 |
The problem is that if you do that, it opens the insurance company up to the risk of adverse 00:07:09.400 |
It breaks the model because people who are sick and have a lot of health problems are 00:07:14.840 |
much more likely to want insurance than those who are healthy and don't have any known health 00:07:21.780 |
And so if the sample of insureds in a health insurance risk pool is not representative 00:07:29.560 |
of the general population, then the actuarial tables that govern the pricing of insurance 00:07:38.960 |
So because the legislative intent was to open up health insurance to every person, regardless 00:07:45.680 |
of preexisting condition, regardless of how bad of a health risk somebody is, there had 00:07:51.840 |
to be some kind of mechanism in order to try to ensure that the people getting health insurance 00:07:59.680 |
would be reflective of the general population. 00:08:02.760 |
Now given that politically it was not feasible for the legislators in charge at that point 00:08:07.440 |
in time to accomplish what I think most would have liked to have accomplished, which was 00:08:12.800 |
to have a universal government-run health insurance system just like Medicare or Medicaid, 00:08:20.040 |
because that was not politically feasible, they tried to find a compromise position. 00:08:24.640 |
And the compromise position was to incentivize all people to join the health insurance rolls 00:08:30.880 |
by invoking a penalty for the people who chose not to buy health insurance. 00:08:37.240 |
It was hoped that this penalty would incentivize 100 percent – of course they knew it wouldn't 00:08:44.280 |
be 100 percent – but it was hoped that it would incentivize 100 percent of all US Americans 00:08:49.320 |
to go into the world of health insurance, purchase and maintain health insurance coverage 00:08:55.320 |
in order that the health insurance companies could have a risk pool that was actually reflective 00:09:01.200 |
of the entire population because it included the entire population. 00:09:08.500 |
Now this penalty faced a couple of difficult legislative options. 00:09:13.780 |
It was adjudicated all the way up to the Supreme Court and quite famously it was defended as 00:09:19.220 |
it not being a tax and then it was called to be a tax. 00:09:21.960 |
Anyway, we'll skip the legislative history of it. 00:09:24.920 |
But it was adjudicated up to the Supreme Court and the Supreme Court ruled that it was indeed 00:09:32.280 |
It was quite the remarkable and interesting judicial history where the congress evidently 00:09:38.720 |
unintentionally wound up advocating and establishing a constitutional tax based upon the ruling 00:09:46.800 |
So that system of penalties or let's call it tax has been in place. 00:09:52.600 |
But there's been a lot of confusion about it because it started off not being very much 00:09:57.120 |
It started off being only a couple of hundred dollars in terms of the actual cost and many 00:10:00.700 |
people made the decision that they did not value having health insurance to the degree 00:10:12.000 |
I'm not one of those who just automatically dismisses that. 00:10:15.200 |
I think that it's your money and you can make a rational and careful and thoughtful decision 00:10:21.720 |
I do not fault the many people who make a conscious decision to avoid having health 00:10:30.100 |
We'll cover that in a participate in a health sharing program. 00:10:32.800 |
My intention is to do that with the next episode probably tomorrow. 00:10:35.920 |
So I don't think it's irrational not to have health insurance. 00:10:41.840 |
There's a cost and a benefit of all things and you have to weigh the costs and you have 00:10:45.600 |
to weigh the benefits and you're the one who knows the most about your personal situation. 00:10:50.060 |
That's what leads to the problem of adverse selection. 00:10:52.480 |
Those of you who are very healthy, who don't have any pre-existing health conditions, who 00:10:56.000 |
aren't aware of any known maladies, who generally have a fairly safe lifestyle, I think it's 00:11:01.960 |
a perfectly sensible and rational economic decision to say that I'll choose to self-insure 00:11:07.560 |
the potential risk of my health expenses and I just simply will forego participating in 00:11:16.560 |
In general, health insurance does provide a very important financial backstop against 00:11:25.640 |
But when the cost of the premiums rises to the point where it's almost inevitable financial 00:11:31.000 |
ruin based upon paying the premiums, the whole point of health insurance basically conceptually 00:11:37.920 |
So in the beginning years, these penalties that were imposed for Obamacare were relatively 00:11:44.920 |
I can't remember the first year was $195, $295, something like that. 00:11:51.920 |
So let's talk about how to actually calculate the fees so that you can understand the potential 00:11:59.000 |
Now here I'm going to be referencing the information that is available directly from healthcare.gov. 00:12:04.720 |
I'm actually going to read their paperwork and read their financial calculations to you 00:12:12.080 |
And this information is current as for 2015, excuse me, 2016. 00:12:19.520 |
If you don't have health insurance or didn't have health insurance throughout 2016. 00:12:24.920 |
The fee that you would pay, they still call it a fee. 00:12:27.880 |
They should call it a tax because that was what it was ruled as. 00:12:30.160 |
Anyway, the penalty tax that you will pay is calculated in two different ways and you 00:12:40.240 |
Again there are two calculations and you will pay the higher calculation. 00:12:47.960 |
These fees will adjust with inflation so you have to rerun the calculation each year. 00:12:52.840 |
The first way that the penalty tax is calculated is based upon a percentage of income. 00:13:02.440 |
And your tax, if you do not maintain health insurance coverage, will be 2.5% of your annual 00:13:15.560 |
Again your tax will be 2.5% of your annual household income. 00:13:25.760 |
If you have a $1 million annual household income and you do not have health insurance, 00:13:37.760 |
The reason is that the maximum amount here is the total yearly premium for the national 00:13:44.440 |
average price of a bronze health insurance plan that is sold through the marketplace. 00:13:50.400 |
So bronze premiums for a bronze insurance plan would be significantly below $25,000 00:13:56.700 |
Bronze is the lowest tier plan that's offered and the bronze, silver, gold classification 00:14:06.600 |
The idea is if you're going to be paying 2.5% of your income and it's going to be at 00:14:14.080 |
least as much as the cost of a bronze plan, then why would you not go ahead and get the 00:14:25.800 |
Recognizing also that of course we have the premium tax credits which make a substantial 00:14:30.240 |
difference in the cost of the insurance programs for those who are lower to middle income. 00:14:35.960 |
And those numbers as we referenced in episode 397 called the health insurance series part 00:14:43.720 |
3, the premium tax credit, what it is, how it works and how to maximize your cash from 00:14:48.880 |
As we referenced those numbers there in that show, the premium tax credit will have a high 00:14:52.760 |
degree of impact on low to even middle to middle upper income households. 00:14:59.800 |
So way of calculating fee number one, percentage of income, it's 2.5% of your household income 00:15:05.120 |
subject to a maximum which is the average total yearly premium for the national average 00:15:13.160 |
price of a bronze plan that's sold through the health insurance marketplace. 00:15:18.840 |
The other way that the fee is calculated is as a flat fee of $695 per adult and $347.50 00:15:37.000 |
So let's just call it $700 per adult and $350 per child. 00:15:44.000 |
Flat fee and this is how the penalty is taken out of the world of income because some people 00:15:50.240 |
don't have a high income and so therefore this is where the penalty is taken out. 00:15:54.720 |
Now this calculation is subject to a maximum annual penalty of $2085. 00:16:03.520 |
So if you were to run the math on that, let's just call it $2000 minus $700 for one adult 00:16:08.440 |
in the household minus $700 for a second adult in the household, you're left with $600. 00:16:13.960 |
Basically you wind up with two adults and two children in a household and you're going 00:16:17.780 |
to be over the maximum fee, maximum amount $2085. 00:16:22.800 |
You will pay whichever of these numbers is higher. 00:16:32.520 |
When using the percentage method, only the part of your household income that's above 00:16:39.280 |
the yearly tax filing threshold, which is $10,150 for individuals or $20,300 for couples 00:16:47.820 |
filing jointly in 2014, which is the most recent year available, is counted. 00:16:53.640 |
If your income is below the threshold for a requirement to file tax returns, yes, it 00:17:01.800 |
is possible for you not to be required to file a tax return if your income is low enough. 00:17:05.760 |
If your income is below that threshold, you won't incur the penalty. 00:17:09.320 |
But the income that is below that number is not counted in these penalties. 00:17:16.820 |
Using the per person method, you pay only for people in your household who don't have 00:17:27.400 |
Again, using the per person method, you pay only for people in your household who don't 00:17:34.720 |
So your fee will not include people who do have coverage. 00:17:40.320 |
If you have coverage for part of the year, the fee is 1/12th of the annual amount for 00:17:47.800 |
each month you or your tax dependents don't have coverage. 00:17:54.380 |
If you're uncovered only one or two months, you don't have to pay the fee at all. 00:18:00.660 |
So that's where one of the exemptions, if you're just missing coverage for one or two 00:18:04.360 |
months, there is no fee, but if it's more than that, then the fee is prorated for each 00:18:13.980 |
And finally, you pay the fee when you file your federal tax return for the year that 00:18:19.040 |
So let's do a few numbers here, some examples that the IRS gives us in their guidance documents 00:18:25.000 |
here from healthcare.gov so that we can understand how this works. 00:18:28.420 |
If you numbers make your eyes swim, just skip forward a couple of minutes. 00:18:32.860 |
Example number one, a single individual with $40,000 of income. 00:18:36.780 |
Jim, who is unmarried with no dependents, doesn't have qualifying health coverage for 00:18:52.100 |
His per person fee would be $695 just for him. 00:18:57.300 |
His percentage of income fee would be calculated in this way. 00:19:01.680 |
You take $40,000, his 2016 household income, subtract $10,150, which is the tax filing 00:19:09.500 |
threshold for individuals in 2014, the most recent year available, which equals an annual 00:19:20.780 |
Then you take 2.5% of that number, 2.5% of $29,850 would be $746.25. 00:19:31.060 |
The annual national average premium for a bronze plan is $2,448. 00:19:37.780 |
$746.25, which is Jim's percentage of income fee, is less than $2,448, which is the maximum 00:19:49.040 |
percentage of income fee, so the maximum doesn't apply. 00:19:52.220 |
But $746.25, Jim's percentage of income fee, is higher than $695, his per person fee. 00:20:01.060 |
So his 2016 tax penalty would be $746.25, which he would pay upon the filing of his 00:20:12.060 |
Now if he'd had partial coverage for any month of 2016, he would ... not partial coverage. 00:20:18.800 |
If he'd had health coverage for any month of 2016, then he would just simply owe 1/12 00:20:23.900 |
of the annual fee for each month that he's uninsured. 00:20:29.100 |
Example number two, married couple with two children, $70,000 of income. 00:20:33.300 |
Eduardo and Julia are married and have two children under 18. 00:20:36.620 |
I guess I kind of assumed Julia, and it says Julia. 00:20:40.660 |
Anyway, Eduardo and Julia are married and have two children under 18. 00:20:44.540 |
No family member has qualifying health coverage for any month of 2016, and the 2016 household 00:20:52.640 |
So first calculate the per person fee, $2,085, which is two adults at $695 each, plus two 00:21:05.500 |
Percentage of income fee, you take $70,000, subtract out the $20,300 tax filing threshold 00:21:11.480 |
for married couples filing jointly, which equals $49,700, and take 2.5% of that, comes 00:21:22.200 |
You take the maximum cost of the bronze plan, average national premium for that size family 00:21:27.400 |
would be $9,792 per year, and then you calculate, and obviously the percentage of income fee 00:21:36.080 |
of $1,242.50 would be less than the maximum, so the maximum doesn't apply, but the per 00:21:42.420 |
person fee of $2,085 is higher than $1,242.50. 00:21:49.600 |
Their fee would be the higher one of $2,085, which they would pay when they file the 2016 00:21:59.880 |
Now, even just looking at that number, that would be a scenario that is common. 00:22:11.480 |
Married couple, two children, $70,000 household income. 00:22:21.920 |
Well, it depends on the cost of the bronze plan. 00:22:23.800 |
Now, remember the bronze plan here is $9,792. 00:22:32.920 |
Those cost savings would generally be offset by the premium tax credit. 00:22:37.320 |
So I didn't run the numbers in preparation for the show, but they wouldn't be paying 00:22:40.600 |
$9,792 because of the benefit of the premium tax credit. 00:22:47.680 |
But still, $2,085 is a significant discount in terms of, "Okay, fine. 00:22:57.920 |
Hopefully you understand how the fees work and you've seen how these fees have steadily 00:23:05.020 |
Most people are not going to choose, even if they have other reasons not to participate 00:23:09.480 |
in the health insurance marketplace, most people aren't going to choose to incur a $2,000 00:23:13.760 |
fee when they could come up with some other option, including just simply buying the bronze 00:23:19.040 |
plan, having the cost rebated by the premium tax credit, and financially it will make – it 00:23:24.400 |
will tend in their direction where they'll just say, "Well, it makes more sense to go 00:23:27.640 |
ahead and get the coverage through the healthcare.gov website." 00:23:38.040 |
Now, this is one of the more interesting and controversial questions that I've been aware 00:23:47.280 |
I researched it as extensively as I could in preparation for this show. 00:23:52.880 |
Still, I'm even in some ways uncomfortable talking about it because it seems so counterintuitive. 00:23:58.440 |
But at this point in time, the penalty for not paying – the consequences for not paying 00:24:11.640 |
Then I'll read a couple – an article that goes into details. 00:24:15.240 |
But basically, as I understand the current law and the current circumstances, the only 00:24:21.240 |
way that the IRS – because the IRS was tasked with collecting these penalty fees. 00:24:26.280 |
The only way that the IRS can collect the Affordable Care Act penalty is if you choose 00:24:32.800 |
to pay it voluntarily or if they take it out of a refund that is due to you. 00:24:48.820 |
In the United States of America, if you owe tax and if you do not pay your tax, the IRS 00:24:55.840 |
has been granted the legal authority to impose significant negative sanctions on you. 00:25:03.240 |
These sanctions would include the garnishment of your wages. 00:25:08.040 |
These sanctions would include the cleaning out of your accounts, bank accounts. 00:25:14.280 |
These sanctions would include the repossession of – involuntary repossession of your property, 00:25:22.740 |
They can come and take your physical assets, take your furniture, take your house, take 00:25:33.060 |
The IRS has legal authority to, upon successful judgment, lawsuit, etc., to put you in prison 00:25:42.560 |
The full weight of the law comes down upon you if you do not pay taxes. 00:25:46.580 |
Now they generally only do this as an example. 00:25:51.000 |
The IRS depends upon voluntary taxpayer support, voluntary taxpayer participation in order 00:25:58.180 |
to manage the tax system in the United States of America. 00:26:01.220 |
If a large percentage of the population decided not to pay taxes, there would be no workable 00:26:08.080 |
solution for the government authorities to impose their will on the population. 00:26:16.400 |
Best example would be the problem with immigration. 00:26:19.620 |
People can – as far as illegal immigrants in the United States of America, there are 00:26:23.460 |
millions, tens of millions of illegal immigrants in the United States of America. 00:26:27.260 |
But nobody has any possible plan, no possible way to deport systematically all of those 00:26:36.540 |
And so we kind of continue in this uncomfortable detente situation where nobody can really 00:26:41.520 |
do much about it except move a little bit of symbolism and try to get people to make 00:26:47.700 |
That's why one of President-elect Trump's ideas that he promotes is – has an intended 00:26:55.460 |
goal of encouraging self-deportation where people voluntarily choose to leave the country. 00:27:04.660 |
So with the tax system here, the tax system functions on the same basis. 00:27:09.460 |
And so the IRS generally doesn't go after low-level tax for much of the time when you 00:27:19.780 |
Sometimes it's computer-generated inquiry, some simple back and forth. 00:27:24.060 |
They don't sue normal people with small incomes for tax fraud. 00:27:30.700 |
They do sue high-profile people they can make an example out of. 00:27:33.540 |
This is a way that you control a population is you make an example out of a few cases. 00:27:39.900 |
This instills fear and respect among the population and most people voluntarily comply. 00:27:45.980 |
But the trick is that the Affordable Care Act penalty does not have – that the IRS 00:27:51.940 |
does not have the same legal authority under today's laws, does not have the same legal 00:28:02.940 |
If you don't pay the penalty and if you don't pay it year by year by year by year, 00:28:05.980 |
let's say you incur a $2,000 penalty and at the end of 10 years, you owe $20,000. 00:28:10.980 |
The IRS does not have the legal authority to garnish your wages for the $20,000 or to 00:28:21.800 |
They have to wait for you to send in a check or if you've made the mistake by sending 00:28:27.660 |
in too much money for tax for other income tax, they can take it from a refund. 00:28:34.980 |
If you owe them $20,000 for the health insurance tax penalty and you are owed a refund because 00:28:41.620 |
you had your employer deduct your wages and send that money in or you made quarterly payments 00:28:47.860 |
for your income tax to the IRS and at the end of the year, you calculate things and 00:28:51.380 |
you're owed a $5,000 refund, the IRS can legally choose to keep that refund and use 00:28:58.480 |
that to work towards satisfying the $20,000 that you owe them. 00:29:04.260 |
But beyond that, I cannot find any evidence that there are any other enforcement mechanisms 00:29:13.780 |
Now this story and these facts have been very interesting to me since for the last five 00:29:18.400 |
or six years through the whole integration of the legislation. 00:29:23.380 |
Now I didn't have to face that decision myself but I had researched it myself and I couldn't 00:29:27.700 |
find any offsetting information but I always felt slow to want to talk about that publicly 00:29:39.980 |
Here's an article from Kelly Phillips Erb from writing in Forbes magazine, at least 00:29:49.700 |
Last month, the Obama administration announced that between three and six million households, 00:29:53.700 |
about two to four percent of taxpayers, would be faced with a penalty at tax time for failing 00:29:58.420 |
to secure minimum essential coverage to comply with the Affordable Care Act, sometimes referred 00:30:06.020 |
Under Obamacare, you're considered covered if you have insurance through the government, 00:30:09.780 |
including Medicare, Medicaid, CHIP, retiree coverage, TRICARE or VA health coverage, private 00:30:14.420 |
insurance that you purchased on your own, including COBRA coverage, and coverage obtained 00:30:18.500 |
through the health insurance marketplace or provided by your employer. 00:30:22.140 |
You'll report coverage on your tax return, blah, blah, blah. 00:30:24.660 |
Most taxpayers, about 130 million or so, will report coverage. 00:30:28.220 |
Of those who don't have coverage, estimates range from 20 million to 37.5 million, most 00:30:33.620 |
will avoid being subject to the penalty based on a waiver or exemption. 00:30:39.380 |
Those taxpayers who can't demonstrate essential minimum coverage and aren't otherwise exempt 00:30:45.300 |
The shared individual responsibility payment equal to one percent of income above the filing 00:30:54.860 |
So the numbers that I just gave you are current. 00:30:56.260 |
In terms of dollars, the Congressional Budget Office had initially estimated that by 2016, 00:31:01.820 |
nearly 6 million taxpayers would be subject to an average penalty of $1,200. 00:31:07.780 |
The overwhelming majority, 80%, of those estimated to be at risk to the penalty were those in 00:31:12.740 |
the middle class with incomes between $55,850 and $115,250. 00:31:20.340 |
Since that time, the numbers have been adjusted downward, based largely on the perceived success 00:31:24.420 |
of policies purchased through the marketplace and the increased number of taxpayers exempt 00:31:30.400 |
Those estimates between 3 and 6 million households are still just guesses, but the dollars associated 00:31:38.620 |
You see, buried in the language of the 2010 law creating the Affordable Health Care Act 00:31:45.740 |
There are practically no real consequences for not paying the penalty. 00:31:50.340 |
I mentioned this to Maggie McGrath, personal finance reporter for Forbes, while shooting 00:31:53.700 |
video about the Health Care Act earlier this month. 00:32:00.460 |
It should, but oddly enough, nobody is really talking about it. 00:32:07.140 |
Nobody has a clue what's really going to happen. 00:32:09.220 |
You see, when the Act became news in 2010, rumors were flying about what would happen 00:32:18.260 |
The consequences needed to be enough to make you want to conform with the Act, but not 00:32:22.380 |
so onerous that Congress would be loathe to vote for it. 00:32:26.020 |
The final language in the Act declared that the penalty "shall be paid upon notice and 00:32:34.020 |
The language went on to note that the penalty would be "collected in the same manner as 00:32:38.900 |
an assessable penalty under Subchapter B of Chapter 68," which also sounds pretty serious, 00:32:44.780 |
especially since Subchapter B references some pretty nasty penalties for otherwise not complying 00:32:52.040 |
So what would the penalty for noncompliance be? 00:32:56.860 |
The language in the Act specifically rules out jail time, saying at section 500A(g)(2)(a), 00:33:01.900 |
"In the case of any failure by a taxpayer to timely pay any penalty imposed by this 00:33:06.780 |
section, such taxpayer shall not be subject to any criminal prosecution or penalty with 00:33:17.500 |
But that means that the IRS will chase you and lean your property if you don't pay, 00:33:25.180 |
Remember the famous quote, "We have to pass the bill so that we can read it and find 00:33:29.780 |
Here are some of the consequences of that type of approach to lawmaking. 00:33:37.300 |
At 500A(g)(2)(b)(i), "The Treasury cannot file notice of lien with respect to any property 00:33:44.660 |
of a taxpayer by reason of any failure to pay the penalty imposed by this section." 00:33:52.460 |
Then clearly there will be levies or seizures on your wages and account, right? 00:33:57.500 |
Under 500A(g)(2)(b)(ii), "The Treasury cannot 'levy' on any such property with 00:34:06.580 |
To recap then, by law you have to pay the penalty. 00:34:09.980 |
But if you don't, you won't go to jail, you won't be leaned, and you won't be 00:34:14.620 |
Is there anything that could happen to you if you choose not to pay? 00:34:18.140 |
With no jail, no liens, and no levies, it doesn't leave the IRS a lot of room to 00:34:24.780 |
Congress actually managed to create, as I wrote in 2012 and in 2013, "an incredibly 00:34:29.820 |
complex and burdensome law without any teeth." 00:34:37.140 |
The IRS might seize any part or all of your refund in order to satisfy your obligation. 00:34:43.820 |
IRS hasn't come right out and said that it absolutely will offset your refund if you 00:34:49.660 |
However, in the final regulations issued on this matter, IRS noted that "Nothing in 00:34:54.420 |
this section prohibits the Secretary from offsetting any liability for the shared responsibility 00:34:58.820 |
payment against any overpayment due the taxpayer, in accordance with Section 6402(a) and its 00:35:07.660 |
That's sufficiently passive-aggressive, right? 00:35:09.820 |
You're on notice that the IRS doesn't think that it's barred from taking your refund. 00:35:13.580 |
They're not saying they will, for certain, but they're not saying they won't either. 00:35:18.140 |
So is there anything you can expect for sure? 00:35:20.700 |
You can definitely expect a lot of letter-writing and virtual shaking of the government's fist 00:35:24.620 |
at you, maybe even some blustering for good measure. 00:35:30.820 |
Other than that potential refund seizure and a guilty conscience, there's nothing to keep 00:35:41.860 |
Plus ends the article on Forbes by Kelly Phillips Erb, who writes on taxes there. 00:35:51.660 |
My current opinion and understanding is that if you choose not to pay the imposed penalty 00:35:58.080 |
tax for not having health insurance coverage, there are very few negative repercussions 00:36:06.780 |
That's the best that I have been able to figure out. 00:36:09.140 |
Now, you should make sure, for your own safety, that you never wind up in a situation where 00:36:14.460 |
you're expecting a significant refund from the IRS. 00:36:19.540 |
Now, it's not always avoidable, but in general, try to work out your exemptions and your withholdings 00:36:24.780 |
and your quarterly tax payments and such to the point where you're going to have about 00:36:31.100 |
You don't want to get a big refund back at tax time, nor do you want to owe a big check. 00:36:36.100 |
If you owe a big check, you could be subject to penalties for underpayment of tax on your 00:36:45.540 |
But if you get a big refund back, you've given up utility of the money and you've given it 00:36:50.780 |
to the government at a 0% loan and you've subjected yourself to a whole lot of hassle 00:36:55.740 |
Now, lots of people do that because they consider that their savings policy. 00:37:04.180 |
It's kind of hard to get money out of them sometimes. 00:37:06.980 |
They have all the legal teeth and you have nothing. 00:37:09.740 |
So in general, you should calculate your taxes as close to zero as you can. 00:37:13.700 |
It's not always possible, but that's the goal. 00:37:16.320 |
I don't think it's a huge concern if you choose not to pay the penalty as long as you avoid 00:37:22.140 |
Now, my concerns, I wouldn't advocate for that. 00:37:25.540 |
Number one, you still have to face the reality that you don't have any significant health 00:37:32.980 |
In general, it's better to have health insurance coverage. 00:37:38.680 |
Number two, the concern with legislation is I don't see any reason why that legislation 00:37:51.400 |
So if this were to be a problem, let's pretend that we continued with a president-elect Hillary 00:37:57.820 |
Clinton in today's world rather than a president-elect Donald Trump. 00:38:01.660 |
If there wound up being a tremendously high nonparticipation rate by American citizens 00:38:07.740 |
choosing not to pay the penalty fee, I don't see any reason why they wouldn't change the 00:38:16.880 |
Under those circumstances, I think you could change and you could make the argument, "Well, 00:38:19.900 |
if that happens, I'll go ahead and consider paying the taxes. 00:38:22.540 |
But in the meantime, I've had use of the money. 00:38:25.580 |
Now, the third thing is everything regarding the Affordable Care Act at this point in time 00:38:32.460 |
is uncertain and due to the election of president-elect Trump who campaigned upon a promise of repealing 00:38:42.620 |
and later repealing and replacing the Affordable Care Act legislation. 00:38:47.700 |
This is also interesting to watch given the Republican majority in the House and the Senate 00:38:52.700 |
because when this legislation was passed, it was purely done on party lines. 00:38:57.300 |
Every Republican voted against it and every – I don't know if all Democrats voted 00:39:00.820 |
for it but at least all Republicans opposed it. 00:39:04.100 |
So given the massive win, the landslide win based upon the Republican political party, 00:39:09.900 |
there is little – I don't see any major political will that the Republicans – any 00:39:15.020 |
reason for the Republicans not to work towards repealing it. 00:39:19.000 |
The challenge comes from the basis of replacement because there are so many millions of people 00:39:23.900 |
who had pre-existing conditions, who were rightfully cut out of the health insurance 00:39:30.460 |
marketplace that the political bad PR of Republican House, Senate and president saying, "We're 00:39:40.380 |
now going to eject all these people from the health insurance rolls," that bad political 00:39:45.460 |
press, it's hard for me to imagine them having political will to stand up against 00:39:55.540 |
Compassion and the goals of compassion seems to be the driving force of our political ideology 00:40:04.120 |
and compassion for the few is of primary importance and I haven't seen any serious proposal 00:40:10.460 |
that to me has made sense that it can work in order to manage the political realities 00:40:20.800 |
We will continue to observe and see what happens and I'm thankful that I don't have that 00:40:26.900 |
I would be remiss if I didn't point out that you – even though these technical financial 00:40:30.860 |
considerations, they're practical but none of them solves the ethical question of whether 00:40:35.140 |
you should or should not pay the penalty tax. 00:40:39.940 |
I find that a very difficult question to answer and I will simply say that in a past tax year 00:40:47.340 |
when I owed a penalty due to non-possession of health insurance for myself, I – for 00:40:54.180 |
a period of time, I chose to pay the penalty. 00:40:58.940 |
Now, let's talk about some exemptions here because yes, you can choose not to pay the 00:41:06.360 |
penalty and that's quite interesting and somewhat – well, it's provocative and 00:41:12.500 |
But let's talk about some exemptions because there are other exemptions and I've very 00:41:15.340 |
rarely heard these exemptions discussed and perhaps you'll find an exemption here that 00:41:22.860 |
Obviously, the simplest way to avoid paying the penalty tax is by having qualifying minimum 00:41:30.340 |
essential health insurance coverage and the Affordable Care Act has been effective at 00:41:40.500 |
If you remove the problem of pre-existing conditions, that's what the Affordable Care 00:41:46.700 |
Act did, and if you remove the problem of so-called affordability, which is what the 00:41:53.600 |
premium tax credit as well as the expansion of Medicaid effectively does for most people, 00:42:00.460 |
there are very few non-ideological reasons to participate in the federal health insurance 00:42:11.700 |
So for most people, they can simply avoid the penalty by signing up for insurance and 00:42:18.980 |
Now, the challenge here becomes if the pricing changes and that's what has dogged the heels 00:42:26.060 |
of the Affordable Care Act legislation and it only appears to be getting worse. 00:42:30.140 |
Because the market was so fundamentally unstable, it was so financially poorly calculated, then 00:42:36.460 |
there doesn't seem to be any way that the marketplace can continue based upon the current 00:42:41.580 |
Now, that doesn't necessarily reflect, in my opinion, through to the general population 00:42:46.060 |
because most people who are lower and middle income people are receiving that premium, 00:42:52.060 |
who are not participating at their work, et cetera. 00:42:54.220 |
I'm talking about the people who are enrolled through healthcare.gov. 00:42:56.780 |
Because most of these people are receiving the premium tax credit and because their premium 00:43:02.300 |
is calculated based upon affordability, they're not seeing the true cost and the true cost 00:43:09.820 |
It's only the accountants who are seeing that. 00:43:13.200 |
So most people are not upset who are on the health, the actual impact of the rising premiums 00:43:18.340 |
seems to be relatively controlled for most people who are participating in the Affordable 00:43:23.140 |
Care Act and who are receiving the premium tax credit. 00:43:27.140 |
It's only behind the scenes that the costs are falling apart. 00:43:30.720 |
So most people can just simply choose to sign up for and get the Affordable Care Act coverage. 00:43:43.020 |
There are markets where a significant number of insurers are pulling out of the healthcare.gov 00:43:48.680 |
They are losing money hand over fist and this change of supply is also having some significant 00:43:56.180 |
But you can sign up for insurance and there are lots of reasons. 00:44:01.980 |
Plus there are lots of qualifying life events. 00:44:04.180 |
If you recently get married, if you recently get divorced, if you had the birth of a child, 00:44:09.620 |
those are ways that you can sign up and get coverage. 00:44:13.560 |
You can also buy qualifying health insurance coverage through your employer. 00:44:17.820 |
You can still in theory buy it on the private market or you can qualify for Medicaid if 00:44:22.680 |
your income fits into the appropriate numbers. 00:44:27.320 |
But the Affordable Care Act legislation does list a couple of important exemptions. 00:44:31.820 |
Let's talk about those so that you know what they are. 00:44:34.180 |
The first one which to me is actually one of the more interesting ones is homelessness. 00:44:41.660 |
If you qualify as being homeless, you can maintain an exemption from that Obamacare 00:44:54.220 |
Now, the reason this is interesting to me is my brain works where I generally look for 00:44:59.420 |
For example, Medicaid is not based upon – at least in my state and in most states as I 00:45:05.380 |
understand the law – Medicaid is not based upon the number of assets that you have. 00:45:10.060 |
It's based upon the amount of income that you have. 00:45:13.180 |
So there are many of you who are listening to the audience and there are many people 00:45:15.500 |
who I've interviewed and profiled on the show who live on a very small monthly budget 00:45:28.100 |
This is highly advantageous when it comes to tax planning. 00:45:31.780 |
It is absolutely possible that you, if you lived in a paid-for house or had living arrangements 00:45:40.060 |
that didn't require a high amount of monthly rent payments, simplest one would be a paid-for 00:45:43.980 |
house in an area with low property taxes, etc. 00:45:47.540 |
If you had a paid-for house, no debt payments, cars weren't functional but no monthly payments, 00:45:57.260 |
you could live a very comfortable lifestyle, especially in our modern economy, on relatively 00:46:02.820 |
little income, which requires you, regardless of the amount of your net worth, to not pull 00:46:10.900 |
a lot of income off of your portfolio of assets. 00:46:16.640 |
If you compound that approach, no house payment, minimal property taxes, no significant asset 00:46:24.060 |
payments like car payments, if you compound that with some appropriate investments that 00:46:30.260 |
allow you to shelter some income through depreciation expenses or depletion expenses, and if you 00:46:36.660 |
compound that with having your own business, which allows you to offset any portion of 00:46:42.540 |
your expenses that are due to your business activities, it's very possible that you could 00:46:51.340 |
live a great lifestyle on a relatively low income and be perfectly comfortable. 00:46:58.740 |
Well, that relatively low income could, in theory, checking on the numbers in your state, 00:47:06.820 |
allow you to qualify for Medicaid and thus to be exempt from the health insurance coverage, 00:47:13.180 |
excuse me, the penalty taxes, and to get health insurance on the dole without you having to 00:47:21.980 |
If you were alternatively forced with, let's say, paying expenses of a couple thousand 00:47:26.260 |
dollars a month for health insurance, which would not be unreasonable in some situations, 00:47:35.200 |
That's also available to you through the premium tax credit system. 00:47:39.500 |
So we wind up with this very interesting and strange effect of the US tax code where you're 00:47:45.060 |
penalized for earning a lot of money, but you're not penalized for being rich. 00:47:52.340 |
Well, if that's the way the law is written, then if you can fit your lifestyle expenses 00:48:02.580 |
So whenever I read a regulation, back to the Power of Choice series that I did in previous 00:48:07.020 |
episodes of the show, whenever I read a regulation, I just want to know, "Okay, what defines that? 00:48:12.580 |
And so hardship category number one is actually extremely interesting to me. 00:48:20.820 |
So I'm here reading the ... Right in front of me, I have the hardship exemption application 00:48:27.780 |
that would need to be submitted for approval when filing taxes based on the healthcare.gov, 00:48:34.060 |
and it tells me that I need to submit documentation. 00:48:38.980 |
Page three of six of the official document that I found on healthcare.gov while reading 00:48:46.900 |
You must provide documentation that one, supports the reason that you're requesting the exemption, 00:48:52.380 |
and two, includes dates showing when you experienced the hardship. 00:49:02.500 |
Those are the stated ... That's the state that is being described. 00:49:18.300 |
So then I go on and I read the application here. 00:49:20.340 |
It says that I need to put in my name, my address, or leave blank if you don't have 00:49:25.820 |
I need to put in my city, my phone number, my email address, my preferred spoken language, 00:49:31.300 |
I need to give them information about my tax household, tell them about the people in my 00:49:36.660 |
Now here where I talk about the hardship, I choose option one, homeless. 00:49:40.420 |
The tax year for which I need the exemption, the date the hardship started, and the date 00:49:51.140 |
So basically all it requires me to say is to affirm that I'm homeless. 00:50:01.100 |
But if you were homeless, then you may be eligible for the hardship exemption here to 00:50:15.060 |
I don't know what the definition of homeless is and I don't see any guidance in the documents. 00:50:19.060 |
So you'll have to decide if you are homeless or not. 00:50:22.440 |
Number two, hardship category number two, you were evicted or were facing eviction or 00:50:29.980 |
Either you would be required to submit documentation of your eviction or of your foreclosure notice 00:50:38.100 |
Now this one was confusing to me because on the application it says that they require 00:50:42.300 |
documentation of the eviction or foreclosure notice in the last three years. 00:50:45.900 |
But on the instructions, which I also read, it indicates that if you were evicted in the 00:50:49.820 |
past six months and were facing eviction or foreclosure, then that would be a problem. 00:50:54.540 |
I don't think that would be useful for the majority of the listening audience, but you 00:51:00.860 |
Next one, same category, hardship number three, you received a shutoff notice from a utility 00:51:05.340 |
You must submit documentation of a shutoff notice from a utility company which state 00:51:11.260 |
And this must be within the last three years. 00:51:16.640 |
Number four, you recently experienced domestic violence. 00:51:23.340 |
Now this is one of those areas where it's not fun to talk about because it affects people 00:51:31.740 |
And I don't know how they would even indicate this because – or how they would even – I 00:51:38.300 |
don't know how they would know whether to approve the hardship exemption or anything 00:51:43.780 |
Now we understand conceptually what that means, but what is it actually? 00:51:47.460 |
What's the definition of domestic violence and how do you demonstrate it? 00:51:52.520 |
So I will just simply read it to you and move on. 00:51:55.260 |
Number five, you experienced the death of a close family member within the last three 00:51:59.300 |
If that's the case, you may qualify for a hardship exemption. 00:52:02.380 |
Proof of documentation needed, death certificate, death notice from newspaper, funeral service 00:52:05.940 |
program, funeral expenses, coroner's report, military notification of death or other official 00:52:13.140 |
That one would just simply be something to be on your radar screen that if you experienced 00:52:16.540 |
the death of a family member, you should apply for this exemption. 00:52:19.980 |
Six, you experienced a fire, flood or other natural or human-caused disaster that caused 00:52:27.860 |
Proof of documentation, police or fire report, insurance claim or other document from a government 00:52:32.240 |
agency or news source about the event that occurred within the last three years. 00:52:38.100 |
Category seven, you filed for bankruptcy, must submit official bankruptcy filing documents 00:52:43.980 |
Eight, you had medical expenses you couldn't pay. 00:52:50.420 |
That's the hardship exemption that you can apply for. 00:52:54.180 |
So you must submit medical bills from the last three years. 00:52:59.060 |
Nine, category nine, you experienced unexpected increases in necessary expenses due to caring 00:53:16.580 |
Now this one I think has promise for some of you listening who are looking to avoid 00:53:26.220 |
Many of us would fall into this situation where we have unexpected increases in necessary 00:53:31.180 |
expenses due to caring for an ill, disabled or aging family member. 00:53:38.140 |
I do know that most families who are caring for an aging family member find themselves 00:53:48.820 |
There's no further indication of what that is. 00:53:54.160 |
The documentation that you need to submit for this is receipts for bills or services 00:53:57.560 |
related to care like medical bills, home care services or transportation receipts from the 00:54:06.220 |
Category 10, a child you expect to claim as a tax dependent has been denied coverage in 00:54:11.740 |
Medicaid and the Children's Health Insurance Program, CHIP, and another person is required 00:54:16.420 |
by court order to give medical support to the child. 00:54:20.480 |
In this case, the court, you have to submit a court order that covers the time period 00:54:23.460 |
for which you want the exemption for the tax dependent and copies of eligibility notices 00:54:27.900 |
showing the dependent has been denied Medicaid and CHIP coverage, must be within the last 00:54:32.780 |
So this is one should just simply be on your radar screen. 00:54:35.660 |
Eleven, as a result of a health insurance marketplace appeals decision, you're eligible 00:54:40.620 |
either for one, enrollment in a qualified health plan through the marketplace, two, 00:54:45.420 |
lower costs on your monthly premiums or three, cost sharing reductions for a time period 00:54:49.980 |
when you weren't enrolled in a marketplace plan. 00:54:52.540 |
In this case, you must submit documentation of health insurance marketplace notice of 00:54:58.060 |
The notice must show the names of everyone in your tax household who wants this exemption. 00:55:01.740 |
Twelve, an adult in your tax household was determined ineligible for Medicaid because 00:55:06.580 |
your state did not expand eligibility for Medicaid under the Affordable Care Act. 00:55:13.940 |
This is for those of you in states that are required to expand their Medicaid rolls to 00:55:19.380 |
include households who are earning up to 133% of the federal poverty level guidelines. 00:55:26.280 |
And so if your state did not do that, then you would qualify for Medicaid, but because 00:55:33.960 |
your state didn't increase the Medicaid, then you might qualify for the exemption from 00:55:40.960 |
Submit notice of denial of eligibility for Medicaid. 00:55:43.660 |
The notice must be from a date during the time period for which you're requesting 00:55:47.560 |
Number 13 and number 14 here are our final two. 00:55:50.520 |
You got a notice from a current health insurance plan that you purchased on the individual 00:55:54.000 |
market, not job-based coverage, saying your policy will be canceled because it doesn't 00:55:58.360 |
meet Affordable Care Act requirements and you consider other available plans unaffordable. 00:56:08.040 |
Many, many health insurance plans were canceled. 00:56:10.560 |
This was the most frustrating thing when I was doing health insurance was I had prior 00:56:14.240 |
to 2010, I had sold a number of health insurance policies. 00:56:17.680 |
And what I'd like to sell was I didn't do much group insurance, but what I did was 00:56:22.400 |
I just – there were just awesome individual health insurance policies available, cheap, 00:56:28.200 |
just pure catastrophic coverage, which is my favorite model for health insurance. 00:56:31.560 |
For people who are healthy, it's the best model. 00:56:35.240 |
But just pure catastrophic coverage, individual policy, not connected to any work, very high 00:56:43.400 |
Well, the vast majority of those were canceled. 00:56:46.680 |
First premiums were raised and then they were just canceled. 00:56:48.880 |
I had many unhappy clients who liked that approach. 00:56:53.240 |
But because of the requirements for minimum essential coverage, all my male clients had 00:56:57.360 |
to have policies that had coverage for pregnancy and had to cover all this stuff and the premiums 00:57:01.760 |
went up and the policies were no longer eligible. 00:57:04.260 |
So if you got a notice from a current health insurance plan that you purchased on the individual 00:57:07.960 |
market, not job-based coverage, saying that your policy will be canceled because it doesn't 00:57:12.880 |
meet Affordable Care Act requirements and if you consider other available plans unaffordable, 00:57:18.840 |
you qualify for an exemption from the penalty tax. 00:57:25.160 |
You must submit documentation which contains a notice of a cancellation from the insurance 00:57:29.280 |
company and the notice must show the names of everyone in your tax household who wants 00:57:34.440 |
Finally, number 14, you can apply for an exemption if you experienced a hardship that kept you 00:57:39.760 |
from getting health insurance that's not listed in the previous 13 categories. 00:57:44.840 |
If so, you would take that on an ad hoc basis. 00:57:51.720 |
And by the way, the process for these is that you submit an application to the healthcare 00:57:57.800 |
administration, they send you back a letter, notice of approval, something like that, and 00:58:02.080 |
they give you an exemption certificate number if you qualify and that's the exemption certificate 00:58:06.800 |
number that you would list on your tax return. 00:58:09.040 |
So there is a process of submitting an application and then receiving approval or request for 00:58:18.000 |
Now there are other exemptions which you also need to be aware of. 00:58:21.300 |
Those are only simply the hardship exemptions. 00:58:23.480 |
But it's good for you to have those on your mental radar screen. 00:58:27.920 |
I hate to overuse the cliche but just to be aware of them so that if you or a friend is 00:58:33.360 |
in that situation that you know of them so that you can avoid paying that penalty which 00:58:43.120 |
Because oftentimes what happens, here's why this is so important, why I labored through 00:58:49.100 |
Many times people don't have health insurance because their life is in turmoil. 00:58:55.520 |
They've gone through the death of a family member, they've had a serious illness, they've 00:59:01.080 |
lost their job, they've been evicted or foreclosed, etc. 00:59:04.700 |
These are the circumstances in which people often wind up just everything falling apart 00:59:13.600 |
So focus on paying for food and putting gas in the car so they can go to a job interview, 00:59:21.520 |
But they often don't go through and try to apply for all of the situations or maybe it's 00:59:25.920 |
not open enrollment period and thus they're not eligible to apply for coverage through 00:59:31.620 |
healthcare.gov or they just don't get around to it. 00:59:34.000 |
Well, if you're aware of these hardship exemptions, you may be able to help somebody save a significant 00:59:37.860 |
amount of money when it comes time to filing their taxes. 00:59:42.700 |
Let's talk about some of the other exemptions because some of these other ones are important. 00:59:48.280 |
I already mentioned earlier that if you don't have to file a tax return because your income 00:59:52.380 |
is below the level that requires you to file, which that number again is about 10 grand 01:00:00.420 |
If you're below that level, then you automatically aren't going to be paying the penalty tax. 01:00:07.080 |
So if your income is below the amount requiring you to file a tax return, you are going to 01:00:14.500 |
Also the other income related exemption is this. 01:00:18.020 |
You'll be exempt from the penalty tax if the lowest price coverage available to you through 01:00:23.940 |
either a marketplace or job-based plan would cost more than 8.13% of your household income. 01:00:36.260 |
So if you're being offered coverage but it's just a much higher percentage than either 01:00:41.260 |
through your job or through a marketplace, then you could qualify for the income related 01:00:47.820 |
There are a couple of coverage related exemptions. 01:00:51.100 |
I read the one that talked about if your state didn't expand its Medicaid program. 01:00:55.180 |
Also I mentioned earlier, if you were uninsured for no more than two consecutive months of 01:00:59.060 |
the year, then you would be exempt from the penalty tax. 01:01:05.020 |
There are some group membership exemptions and here are some of the more interesting 01:01:11.140 |
One, if you're a member of a federally recognized tribe or eligible for services through an 01:01:16.620 |
Indian health services provider, you are exempt from the Affordable Care Act tax penalties. 01:01:29.220 |
A federally recognized tribe is any Indian or Alaska native tribe or Alaska native claim 01:01:35.020 |
settlement act, corporation, regional or village, band, nation, Pueblo, village, rancheria or 01:01:41.240 |
community that the Department of the Interior acknowledges to exist as an Indian tribe. 01:01:46.380 |
If you're a member of an Indian tribe or eligible for services through an Indian health services 01:01:52.100 |
provider, you can be exempt from the penalty tax. 01:01:57.720 |
Also the next one is if you are a member of a recognized healthcare sharing ministry. 01:02:04.920 |
But if you are a member of a recognized healthcare sharing ministry, you can be exempt from the 01:02:11.760 |
Also if you are a member of a recognized religious sect with religious objections to insurance, 01:02:19.020 |
including social security and Medicare, then you can be eligible for an exemption from 01:02:28.300 |
Now this is a category that should be very inclusive of many people, but unfortunately 01:02:34.100 |
due to people bowing down and rolling over to get as much money from the government as 01:02:42.780 |
There are a couple of other small religious sects that qualify. 01:02:45.460 |
But in order to claim this exemption, you have to be a member of a religious sect or 01:02:51.080 |
division that is recognized by the Social Security Administration as conscientiously 01:02:55.520 |
opposed to accepting any insurance benefits, including social security and Medicare, and 01:03:02.420 |
that must have been in existence since December 31, 1950. 01:03:07.540 |
Unfortunately for most of us, our forebears rolled over when they shouldn't have, and 01:03:14.320 |
Next exemption is if you're incarcerated, then you are exempt from the Affordable Care 01:03:22.180 |
And finally, if you are a US citizen living abroad, a certain type of non-citizen or not 01:03:27.520 |
lawfully present in the United States, then you can qualify as being exempt from the Affordable 01:03:40.220 |
The term lawfully present includes immigrants who have "qualified non-citizen immigration 01:03:44.500 |
status without a waiting period, humanitarian statuses or circumstances, or valid non-immigrant 01:03:50.300 |
Now, of course, the one that's interesting that you should also pay attention is the 01:03:57.220 |
If you're a US citizen living abroad, and here are the definitions of that, because 01:04:01.200 |
for those of you in the perpetual travel world, etc., you should pay attention to this. 01:04:06.180 |
That means that you are a US citizen who either spent at least 330 full days outside of the 01:04:12.420 |
United States during a 12-month period, or was a bona fide resident of a foreign country 01:04:21.380 |
Or it means that you're a resident alien who both was a citizen of a national – citizen 01:04:26.700 |
or national of a foreign country with which the US has an income tax treaty with a non-discrimination 01:04:31.500 |
clause and you were a resident alien who was a bona fide resident of a foreign country 01:04:36.260 |
for the tax year, or if you're not lawfully present in the United States. 01:04:45.140 |
For those of you who are into the world of perpetual travel or who live outside of the 01:04:48.820 |
United States, one major thing that that can be compelling in your tax planning is not 01:04:54.020 |
only will you most likely have significant lower health insurance costs depending on 01:04:59.540 |
the country or the region that you're in, depending on how that's structured, but you 01:05:03.020 |
will at least be eligible for this exemption from the US tax penalty. 01:05:13.100 |
So if you've made it this far, congratulations. 01:05:15.460 |
We've worked through that to go through all of those different categories and I congratulate 01:05:21.460 |
you on having the focus to be able to be here an hour and five minutes later where we've 01:05:26.980 |
But those are the details of exemption from the penalty. 01:05:33.540 |
Number one, the information needs to be out there and I'm not aware of it out there 01:05:46.780 |
And so you need to know about these exemptions. 01:05:48.980 |
There are a few of these exemptions that will probably be of particular interest to the 01:05:55.180 |
For example, as I said, the US citizen abroad exemption or perhaps that homelessness exemption 01:06:01.540 |
or perhaps that care of an aging relative exemption, some of the income-based exemptions. 01:06:08.580 |
So in summary, some of your strategies to be able to avoid the Affordable Care Act penalty 01:06:14.260 |
tax, which is the focus and the title of today's show, are these. 01:06:19.540 |
Of course, number one, just simply get health insurance. 01:06:25.580 |
Remember, the premium tax credit is substantial and it substantially offsets the price of 01:06:33.860 |
And under the current law, any person who wants to can go and sign up for health insurance 01:06:38.940 |
coverage under the Affordable Care Act system of health insurance exchanges at healthcare.gov 01:06:47.100 |
On the healthcare.gov website, you will submit your application, put in your information 01:06:50.980 |
for your income, et cetera, and they'll tell you what your monthly premium would be. 01:06:58.740 |
If you would like to increase your subsidies, then simply reduce your income. 01:07:02.940 |
And those subsidies will go up as your income goes down. 01:07:06.340 |
You're incentivized to earn less money in order to have the government pay more of your 01:07:12.980 |
You can get that down if you can get down below that federal poverty level and still 01:07:18.620 |
You can get that down to the point where you'll qualify for Medicaid independent of the amount 01:07:26.260 |
So there is very little cost to health insurance for people who have a low income. 01:07:31.220 |
If you have a medium to high income, then of course that cost will be more significant. 01:07:36.740 |
But if you have a medium to high income, then there are very few reasons not to engage in 01:07:41.020 |
proactive planning regarding your health insurance coverage. 01:07:47.840 |
It's important coverage to protect you from the risk of catastrophic health expenses. 01:07:53.180 |
Now if you choose not to maintain health insurance coverage, then you can just simply pay the 01:07:59.180 |
And depending on those calculations that we did, it may or may not be high. 01:08:03.100 |
Or you can do as I explained and simply choose not to maintain health insurance coverage, 01:08:08.220 |
not to qualify for an exemption, and just don't pay the penalty. 01:08:13.060 |
That is a perfectly reasonable strategy if that fits the details of your circumstance. 01:08:17.300 |
And under the current law, there are very few if any teeth that the IRS has to get the 01:08:29.980 |
If you pursue this route, the route of not maintaining health insurance coverage, remember 01:08:41.220 |
that there are some other alternative ways that you can adjust your health, your insurance 01:08:46.980 |
expenses so that they'll support you in that decision. 01:08:51.300 |
So the simplest, most obvious example is if you are not going to maintain health insurance 01:08:55.900 |
coverage, you should focus highly on being as healthy as possible. 01:09:01.060 |
So perhaps you should allocate a higher percentage of your budget to higher quality food or to 01:09:10.260 |
a more appropriate exercise regime that's going to allow you to maintain a higher degree 01:09:14.100 |
of health or to proactive medical care that you are preventive medical care to help you 01:09:19.980 |
maintain your good health and lessen the risk of catastrophic health expenses. 01:09:25.140 |
You can also adjust some of your other insurance programs. 01:09:29.300 |
Something as simple as disability insurance can be very helpful. 01:09:33.180 |
Long-term care insurance perhaps can be a way of offsetting the health insurance risks. 01:09:38.180 |
These do not cover all your health expenses, but they can be helpful. 01:09:44.060 |
Investigate a strategy such as this, increasing the liability insurance coverage on your property 01:09:48.340 |
coverages, liability insurance coverage for your house and for your car. 01:09:53.620 |
If you have higher amounts of coverage for medical expenses on your car insurance, if 01:09:59.300 |
you think that it's most likely that you're going to get injured in an accident, let's 01:10:03.020 |
say that you're young and you're healthy and you say, "Hey, if I got injured, I'd probably 01:10:08.100 |
Well, then consider increasing your medical coverage cost on your car insurance. 01:10:13.740 |
That may be significantly cheaper than having health insurance and if your calculation is 01:10:18.140 |
correct it might cover you for your situation. 01:10:21.180 |
Or perhaps you engage in some sort of motorsports activity. 01:10:25.540 |
Well, can you make sure that you have medical coverage on your liability coverage that has 01:10:30.060 |
a rider on it covering your participation in that motorsports activity such as your 01:10:34.580 |
four-wheeler or other things that are associated with your house or your RV coverage or whatever 01:10:40.180 |
Read your liability and property insurance documents carefully and see if you can expand 01:10:44.580 |
some coverage there and perhaps that will protect you from the risk of accidents. 01:10:49.540 |
You should also obviously pursue ways to reduce costs such as understanding medical tourism 01:10:54.000 |
and looking for other strategies or if you just need to just consider going and getting 01:10:59.420 |
a job that you take and keep purely for the health insurance coverage. 01:11:03.740 |
So there are many, many options and I hope some of these will spark some creative ideas 01:11:08.160 |
My favorite options are health savings accounts which, excuse me, before I get to my favorite 01:11:13.460 |
one, the challenge with this show is that we are in a bit of legislative limbo and so 01:11:18.460 |
time will tell what happens and it'll be interesting to watch. 01:11:20.980 |
I hope this information is current for a while. 01:11:23.140 |
Now a couple of options that have been my favorites in the past to put as much of – to 01:11:28.380 |
just simply use insurance as a catastrophic protection and put as much of the normal day-to-day 01:11:33.820 |
cost as coming out of your checking account as possible. 01:11:36.940 |
That's why we'll talk in detail about health savings accounts. 01:11:40.020 |
I think they were fantastic inventions a number of years ago and we'll see what happens 01:11:46.260 |
And also we'll talk about healthcare sharing ministries because I believe that if you meet 01:11:50.360 |
the qualifications of participation in a healthcare sharing ministry, then I believe that will 01:11:59.700 |
And my intention is that that will be the very next podcast for you. 01:12:03.980 |
Thank you so much for listening to today's show. 01:12:05.620 |
If this information has been helpful to you, I would ask you humbly to – I would ask 01:12:11.220 |
Please consider becoming a patron of the show. 01:12:13.620 |
The reason that's important is it helps me to bring you the content that I bring you 01:12:18.060 |
with the regularity that I bring it to you and to do so free of commercial encumbrance, 01:12:24.900 |
to do so free of many entanglements and having divided interests. 01:12:29.940 |
My goal is to serve you, my listening audience, and I've sought to set myself up in a way 01:12:35.140 |
where the incentives, my financial incentives for this show are aligned with your best interests. 01:12:41.060 |
But that only works if you voluntarily choose to support me financially. 01:12:48.100 |
One good way to do this is become a patron of the show. 01:12:52.420 |
Sign up to become a supporting patron of the show. 01:12:56.300 |
If every listener of the show supported the show at a buck a month, that would be – I 01:13:02.340 |
would limit almost any other commercial thing and I would just focus on you guys every day 01:13:12.460 |
Basically it winds up that about 2% of the listening audience signs up to support a show, 01:13:21.300 |
But I ask you, consider becoming a patron at RadicalPersonalFinance.com/patron or if 01:13:25.140 |
you'd like to get my personalized advice on your situation, including topics such as 01:13:30.100 |
these, these are the kind of thing that I talk about in consulting calls where I can 01:13:33.100 |
explain to you the exemptions and explain to you your options. 01:13:35.340 |
If you say something like, "Hey, Joshua, I don't have health insurance. 01:13:40.820 |
I can't make recommendations because I no longer maintain an insurance license. 01:13:44.260 |
I can't make recommendations on your buying or not buying insurance." 01:13:47.540 |
But I can say, "If you don't have insurance, then you should consider strategies like I 01:13:50.980 |
said such as adjusting your liability coverage on your car to make sure that it's covering 01:13:57.620 |
These are useful and important planning opportunities regardless of the path that you take.