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RPF0403-How_to_Avoid_the_Obamacare_Tax_Penalty


Whisper Transcript | Transcript Only Page

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.
00:00:12.640 | My name is Joshua Sheets and I'm your host.
00:00:14.560 | Today we continue our discussion on health insurance generally with a specific focus
00:00:20.580 | on Obamacare, specifically today.
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
00:00:46.460 | less left next week as well.
00:00:49.160 | Today we cover three specific topics.
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
00:01:01.600 | impacts you.
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.
00:01:17.640 | That's the content of today's show.
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
00:01:36.480 | Radical Personal Finance Facebook community.
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.
00:01:56.520 | I invite you to join us there.
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
00:02:33.680 | Apple Podcasts app.
00:02:35.520 | It's the app that's automatically installed on your phone.
00:02:38.060 | Pull that little thing open.
00:02:39.060 | Just search.
00:02:40.060 | Use the search function, search podcast, and you'll find it, or it's purple and it says
00:02:43.680 | podcast underneath.
00:02:45.160 | Use the Apple Podcast app and search for Radical Personal Finance in the store and just click
00:02:49.440 | leave a rating and review.
00:02:51.140 | You can just simply leave a quick star rating for the show and one or two sentences on your
00:02:55.880 | phone would be perfect.
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.
00:03:07.360 | Like I said, currently at 333.
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
00:03:21.800 | on your phone.
00:03:22.800 | Super easy if you've never done that.
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.
00:04:11.640 | Review here from LS.
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
00:04:20.000 | and helpful.
00:04:21.000 | He both expanded our thinking while at the same time helped us get focused on a decision."
00:04:25.720 | Another one from JR.
00:04:26.720 | "Amazing call.
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
00:04:59.160 | topics.
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
00:05:07.240 | great deal of value in that.
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.
00:06:15.320 | Again, RadicalPersonalFinance.com/phonecall.
00:06:19.400 | I think you'd be glad you did.
00:06:22.360 | Let's go on and talk about Obamacare now.
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
00:07:08.400 | selection.
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
00:07:20.240 | problems.
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
00:07:36.880 | get broken.
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.
00:09:06.600 | That was the goal.
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
00:09:29.880 | a constitutional tax.
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
00:09:45.800 | of the Supreme Court.
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
00:09:56.120 | money.
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
00:10:07.680 | that it would cost them premiums.
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
00:10:18.540 | about it and I think you should do so.
00:10:21.720 | I do not fault the many people who make a conscious decision to avoid having health
00:10:27.220 | insurance.
00:10:28.220 | I myself do not have any health insurance.
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
00:11:14.120 | the health insurance system.
00:11:16.560 | In general, health insurance does provide a very important financial backstop against
00:11:22.560 | financial ruin.
00:11:23.560 | That's the proper role of health insurance.
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
00:11:35.840 | falls apart.
00:11:37.920 | So in the beginning years, these penalties that were imposed for Obamacare were relatively
00:11:43.420 | small numbers, a few hundred dollars.
00:11:44.920 | I can't remember the first year was $195, $295, something like that.
00:11:49.040 | Today they've gone a little bit higher.
00:11:51.920 | So let's talk about how to actually calculate the fees so that you can understand the potential
00:11:57.120 | impact on your situation.
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
00:12:10.520 | from healthcare.gov.
00:12:12.080 | And this information is current as for 2015, excuse me, 2016.
00:12:17.600 | This is the fees for 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
00:12:34.960 | will pay whichever of these is higher.
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
00:13:11.600 | household income.
00:13:15.560 | Again your tax will be 2.5% of your annual household income.
00:13:23.720 | Now there is a maximum on this.
00:13:25.760 | If you have a $1 million annual household income and you do not have health insurance,
00:13:31.560 | your annual tax will not be $25,000.
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
00:13:55.120 | per year.
00:13:56.700 | Bronze is the lowest tier plan that's offered and the bronze, silver, gold classification
00:14:01.320 | from healthcare.gov.
00:14:03.400 | And so that will be the maximum amount.
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
00:14:21.000 | health insurance policy?
00:14:23.760 | That's the idea here.
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
00:15:32.080 | per child under the age of 18.
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.
00:16:30.120 | A few more details for you.
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
00:17:24.320 | insurance coverage.
00:17:27.400 | Again, using the per person method, you pay only for people in your household who don't
00:17:33.040 | have insurance coverage.
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
00:18:10.520 | month that you don't have coverage.
00:18:13.980 | And finally, you pay the fee when you file your federal tax return for the year that
00:18:17.560 | you don't have coverage.
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
00:18:42.980 | any month of 2016.
00:18:46.060 | His household income in 2016 is $40,000.
00:18:50.820 | So it's simple.
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
00:19:16.060 | income of $29,850.
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
00:20:08.340 | 2016 federal income tax return.
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
00:20:50.220 | income is $70,000.
00:20:52.640 | So first calculate the per person fee, $2,085, which is two adults at $695 each, plus two
00:20:59.620 | children at $347.50 each.
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
00:21:17.800 | out to be $1,242.50.
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
00:21:57.280 | federal income tax return.
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.
00:22:15.440 | They're going to be paying a $2,085 fee.
00:22:20.440 | Is it rational for them to do that?
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.
00:22:30.200 | There's a major cost savings there.
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.
00:22:53.960 | I got to deal with this."
00:22:56.120 | But now we come to the second part.
00:22:57.920 | Hopefully you understand how the fees work and you've seen how these fees have steadily
00:23:01.220 | increased over the last few years.
00:23:02.720 | Until now, they are substantial.
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."
00:23:30.880 | That's the whole point of it.
00:23:33.040 | But here's the question.
00:23:35.120 | What happens if you don't pay the penalty?
00:23:38.040 | Now, this is one of the more interesting and controversial questions that I've been aware
00:23:46.160 | of for the last few years.
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
00:24:06.840 | this penalty are limited.
00:24:10.040 | First I'll describe to you the situation.
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.
00:24:44.160 | This is unlike any other tax law.
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,
00:25:21.560 | of your physical property.
00:25:22.740 | They can come and take your physical assets, take your furniture, take your house, take
00:25:26.480 | your cars, all that stuff and sell it.
00:25:28.760 | These sanctions even include prison.
00:25:33.060 | The IRS has legal authority to, upon successful judgment, lawsuit, etc., to put you in prison
00:25:39.700 | for not paying your taxes.
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
00:26:34.580 | illegal immigrants.
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
00:26:46.420 | actions on their own.
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
00:27:14.900 | get audited or have a problem with the IRS.
00:27:18.140 | It's relatively low-level.
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
00:27:56.720 | authority to extract the tax.
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
00:28:19.340 | seize your property to pay the $20,000.
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
00:29:10.260 | available to them.
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
00:29:32.700 | because it just seemed so out of character.
00:29:38.500 | How could I be right about that?
00:29:39.980 | Here's an article from Kelly Phillips Erb from writing in Forbes magazine, at least
00:29:45.340 | the online edition, from February 26, 2015.
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
00:30:04.500 | to as Obamacare.
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.
00:30:37.380 | We'll talk about exemptions in a minute.
00:30:39.380 | Those taxpayers who can't demonstrate essential minimum coverage and aren't otherwise exempt
00:30:43.460 | are subject to a penalty.
00:30:45.300 | The shared individual responsibility payment equal to one percent of income above the filing
00:30:50.420 | threshold or $94.
00:30:52.860 | These numbers are out of date.
00:30:53.860 | It goes on.
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
00:31:28.900 | under the rules.
00:31:30.400 | Those estimates between 3 and 6 million households are still just guesses, but the dollars associated
00:31:35.000 | with those numbers are the real mystery.
00:31:38.620 | You see, buried in the language of the 2010 law creating the Affordable Health Care Act
00:31:43.840 | is a bit of an out.
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.
00:31:56.580 | Shouldn't that be the real story, she asked?
00:31:59.140 | She's right, of course.
00:32:00.460 | It should, but oddly enough, nobody is really talking about it.
00:32:04.540 | Why so quiet?
00:32:06.100 | Here's my guess.
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
00:32:14.240 | if you didn't pay the penalty.
00:32:15.980 | It was politically tricky.
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
00:32:30.420 | demand," which sounds really intimidating.
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
00:32:49.620 | with other sections of the tax code.
00:32:52.040 | So what would the penalty for noncompliance be?
00:32:54.860 | Jail time?
00:32:55.860 | Nope.
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
00:33:13.060 | respect to such failure."
00:33:15.740 | So no jail time.
00:33:17.500 | But that means that the IRS will chase you and lean your property if you don't pay,
00:33:20.740 | right?
00:33:21.740 | That's not allowed under the Act.
00:33:23.020 | You guys insert my own comments here.
00:33:25.180 | Remember the famous quote, "We have to pass the bill so that we can read it and find
00:33:28.780 | out what's in it"?
00:33:29.780 | Here are some of the consequences of that type of approach to lawmaking.
00:33:34.780 | Nope, that's not allowed under the Act.
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."
00:33:50.420 | So no liens.
00:33:52.460 | Then clearly there will be levies or seizures on your wages and account, right?
00:33:56.180 | Nope, not that either.
00:33:57.500 | Under 500A(g)(2)(b)(ii), "The Treasury cannot 'levy' on any such property with
00:34:03.460 | respect to such failure."
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
00:34:12.540 | levied for collection.
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
00:34:21.900 | work when it comes to collections.
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."
00:34:34.340 | Well, maybe some teeth, baby teeth.
00:34:37.140 | The IRS might seize any part or all of your refund in order to satisfy your obligation.
00:34:42.820 | Might.
00:34:43.820 | IRS hasn't come right out and said that it absolutely will offset your refund if you
00:34:47.780 | owe a penalty for failure to pay.
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
00:35:04.580 | corresponding regulations."
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.
00:35:28.140 | But real consequences?
00:35:30.820 | Other than that potential refund seizure and a guilty conscience, there's nothing to keep
00:35:34.780 | taxpayers from opting out of paying.
00:35:37.900 | Will they?
00:35:38.900 | We'll have to wait and see.
00:35:41.860 | Plus ends the article on Forbes by Kelly Phillips Erb, who writes on taxes there.
00:35:47.940 | Interesting, huh?
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
00:36:03.260 | that you can expect under the current law.
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.
00:36:18.260 | That's a matter of good practice regardless.
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
00:36:29.220 | a neutral scenario.
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
00:36:41.700 | quarterly or withholding calculations.
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
00:36:54.740 | to get it back.
00:36:55.740 | Now, lots of people do that because they consider that their savings policy.
00:36:59.700 | Okay, if you want to do it, fine.
00:37:01.780 | I don't think the IRS is a very good bank.
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
00:37:21.140 | that refund situation.
00:37:22.140 | Now, my concerns, I wouldn't advocate for that.
00:37:24.540 | My concerns are a fewfold.
00:37:25.540 | Number one, you still have to face the reality that you don't have any significant health
00:37:29.400 | insurance coverage.
00:37:31.020 | In general, that's not the best plan.
00:37:32.980 | In general, it's better to have health insurance coverage.
00:37:36.940 | That's important.
00:37:38.680 | Number two, the concern with legislation is I don't see any reason why that legislation
00:37:45.260 | cannot be changed.
00:37:48.060 | Legislation can be changed.
00:37:49.540 | It often is.
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
00:38:13.140 | law and simply give the IRS more teeth.
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.
00:38:24.580 | I can grant that argument."
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
00:39:50.540 | that.
00:39:51.540 | Now, maybe they would, maybe they wouldn't.
00:39:53.300 | It's hard for me to do that.
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
00:40:15.920 | with the financial realities.
00:40:18.800 | Time will tell.
00:40:19.800 | We will see.
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.
00:40:37.540 | And on that, I will leave that to you.
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.
00:40:57.340 | You have to make your own decision.
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
00:41:11.500 | interesting.
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
00:41:19.820 | will cover you.
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
00:41:37.340 | making that possible for all people.
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
00:42:08.720 | programs.
00:42:11.700 | So for most people, they can simply avoid the penalty by signing up for insurance and
00:42:17.620 | that's what most people do.
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
00:42:40.580 | prices.
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
00:43:08.820 | increases.
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.
00:43:41.200 | There are markets where this is changing.
00:43:43.020 | There are markets where a significant number of insurers are pulling out of the healthcare.gov
00:43:47.540 | marketplace.
00:43:48.680 | They are losing money hand over fist and this change of supply is also having some significant
00:43:55.180 | impact.
00:43:56.180 | But you can sign up for insurance and there are lots of reasons.
00:43:59.380 | There's open enrollment.
00:44:00.620 | It's available every year.
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
00:44:53.220 | penalty.
00:44:54.220 | Now, the reason this is interesting to me is my brain works where I generally look for
00:44:57.740 | the angles on things.
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
00:45:21.460 | when measured by their expenses.
00:45:23.420 | It doesn't mean that they're broke.
00:45:25.980 | They just don't have a lot of income.
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.
00:46:13.860 | It's very doable.
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
00:47:20.380 | do anything.
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,
00:47:31.820 | that could be a significant savings.
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.
00:47:49.780 | You're penalized for earning a lot of money.
00:47:52.340 | Well, if that's the way the law is written, then if you can fit your lifestyle expenses
00:47:57.140 | onto a smaller budget, just earn less money.
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?
00:48:11.380 | How do you know that?"
00:48:12.580 | And so hardship category number one is actually extremely interesting to me.
00:48:15.900 | All it says is, "You were homeless."
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.
00:48:37.540 | So let me read this document to you.
00:48:38.980 | Page three of six of the official document that I found on healthcare.gov while reading
00:48:42.900 | about the health coverage exemptions.
00:48:45.100 | Hardship categories and documentation.
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.
00:48:56.220 | So here's hardship number one, category one.
00:48:59.620 | You were homeless.
00:49:02.500 | Those are the stated ... That's the state that is being described.
00:49:09.660 | You were homeless.
00:49:10.660 | You were without a home.
00:49:11.980 | Stated documentation, none.
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,
00:49:29.580 | my preferred written language.
00:49:31.300 | I need to give them information about my tax household, tell them about the people in my
00:49:35.260 | house.
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
00:49:43.980 | the hardship ended.
00:49:45.140 | Check if ongoing.
00:49:49.020 | Read print, I'm signing the application.
00:49:51.140 | So basically all it requires me to say is to affirm that I'm homeless.
00:49:55.980 | I find that to be an interesting definition.
00:50:01.100 | But if you were homeless, then you may be eligible for the hardship exemption here to
00:50:10.860 | help you avoid paying the Obamacare penalty.
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
00:50:27.460 | foreclosure.
00:50:29.980 | Either you would be required to submit documentation of your eviction or of your foreclosure notice
00:50:35.340 | within the last three years.
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
00:50:58.580 | should know that is an exemption.
00:51:00.860 | Next one, same category, hardship number three, you received a shutoff notice from a utility
00:51:04.340 | company.
00:51:05.340 | You must submit documentation of a shutoff notice from a utility company which state
00:51:08.580 | service has or will be shut off.
00:51:11.260 | And this must be within the last three years.
00:51:14.380 | Probably not a factor for most of you.
00:51:16.640 | Number four, you recently experienced domestic violence.
00:51:21.660 | Required documentation, none.
00:51:23.340 | Now this is one of those areas where it's not fun to talk about because it affects people
00:51:29.660 | so deeply.
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
00:51:40.940 | like this.
00:51:41.940 | What is domestic violence?
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?
00:51:51.180 | I don't know the answer to that.
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
00:51:58.300 | years.
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
00:52:10.820 | notice of death.
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
00:52:24.780 | substantial damage to your property.
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
00:52:41.940 | within the last three years.
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
00:53:08.260 | for an ill, disabled or aging family member.
00:53:16.580 | Now this one I think has promise for some of you listening who are looking to avoid
00:53:22.100 | the exemption, excuse me, avoid the penalty.
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.
00:53:34.620 | I don't know what unexpected increases are.
00:53:38.140 | I do know that most families who are caring for an aging family member find themselves
00:53:42.100 | paying much more than they thought.
00:53:45.260 | I don't know what necessary expenses are.
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
00:54:02.260 | last three years.
00:54:04.740 | That's category nine.
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
00:54:31.780 | three years.
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
00:54:56.340 | appeals decision.
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
00:55:38.920 | the penalty.
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
00:55:46.560 | the exemption.
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.
00:56:04.720 | This one affects probably a lot of people.
00:56:07.040 | They got a notice.
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.
00:56:33.520 | If you're sick, it's not.
00:56:35.240 | But just pure catastrophic coverage, individual policy, not connected to any work, very high
00:56:40.960 | deductible, very, very low premium.
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
00:57:33.020 | this exemption.
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.
00:57:49.400 | Those are the hardship exemptions.
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
00:58:13.540 | additional information, etc. from them.
00:58:15.800 | But those are the hardship exemptions.
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
00:58:39.820 | could be substantial for some people.
00:58:43.120 | Because oftentimes what happens, here's why this is so important, why I labored through
00:58:46.640 | all 14 of those categories.
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
00:59:10.220 | and they focus on survival as they should.
00:59:13.600 | So focus on paying for food and putting gas in the car so they can go to a job interview,
00:59:19.620 | Things like health insurance fall behind.
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.
00:59:41.580 | So you should be aware of them.
00:59:42.700 | Let's talk about some of the other exemptions because some of these other ones are important.
00:59:46.340 | There are some income exemptions.
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
00:59:58.460 | for an individual, 20 grand for a couple.
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
01:00:11.100 | be exempt based upon income.
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
01:00:46.820 | exemption.
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
01:01:10.140 | ones.
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.
01:02:02.120 | That's the next episode.
01:02:03.120 | We'll talk about those in detail.
01:02:04.920 | But if you are a member of a recognized healthcare sharing ministry, you can be exempt from the
01:02:08.900 | penalty tax.
01:02:09.900 | This is what I do.
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
01:02:25.340 | the Affordable Care Act tax penalty.
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
01:02:39.180 | possible, this is very, very limited.
01:02:41.740 | Basically just think of the Amish.
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
01:03:11.300 | that will not apply to most of us.
01:03:14.320 | Next exemption is if you're incarcerated, then you are exempt from the Affordable Care
01:03:20.140 | Act tax penalty.
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
01:03:38.620 | Care Act tax penalty.
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
01:03:49.300 | visas, etc."
01:03:50.300 | Now, of course, the one that's interesting that you should also pay attention is the
01:03:54.580 | US citizen abroad exemption.
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
01:04:17.860 | or countries for a full tax year.
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.
01:04:41.900 | And then those are – so that's a key factor.
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
01:05:25.980 | gone through those details.
01:05:26.980 | But those are the details of exemption from the penalty.
01:05:29.980 | Now that penalty used to be insignificant.
01:05:32.260 | Here's why I focus on the show.
01:05:33.540 | Number one, the information needs to be out there and I'm not aware of it out there
01:05:36.660 | in a podcast format.
01:05:37.900 | But the penalty used to be insignificant.
01:05:40.340 | Today that penalty is significant.
01:05:42.540 | It can be many thousands of dollars.
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
01:05:54.180 | listening audience.
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.
01:06:06.540 | These will be of interest to you.
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.
01:06:23.580 | A couple of ways to do that.
01:06:25.580 | Remember, the premium tax credit is substantial and it substantially offsets the price of
01:06:32.180 | the health insurance.
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
01:06:45.140 | or write an open enrollment for that.
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.
01:06:55.240 | And for most people, it's relatively low.
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
01:07:11.060 | health insurance costs.
01:07:12.980 | You can get that down if you can get down below that federal poverty level and still
01:07:16.900 | be able to live somehow.
01:07:18.620 | You can get that down to the point where you'll qualify for Medicaid independent of the amount
01:07:22.500 | of assets that you have.
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.
01:07:44.700 | It is important.
01:07:46.260 | It's important financial protection.
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
01:07:57.620 | penalty.
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
01:08:22.580 | money out of you.
01:08:24.380 | So you can choose to keep it.
01:08:25.940 | Just simply don't pay the penalty.
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
01:10:06.620 | be injured in a car accident."
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
01:10:39.180 | it is.
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
01:11:07.160 | for you.
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
01:11:45.260 | with them in the future.
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
01:11:55.660 | be a useful option for you.
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
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01:12:11.220 | Please consider becoming a patron of the show.
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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.
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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
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01:13:10.380 | Now I don't expect that to happen.
01:13:12.460 | Basically it winds up that about 2% of the listening audience signs up to support a show,
01:13:18.900 | maybe even less at this point in time.
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.
01:13:39.820 | I don't sell 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
01:13:55.820 | medical coverage," things like that.
01:13:57.620 | These are useful and important planning opportunities regardless of the path that you take.
01:14:02.460 | Thank you for listening.
01:14:03.460 | Be back with you soon.
01:14:03.460 | and be back with you soon.