Health tax credit tied to 2012 return
by Anna Oakes
New tax credits will help low- and moderate-income families afford health insurance through new health insurance exchanges under the Affordable Care Act, and the primary method for determining eligibility will be individual tax returns.
Enrollment in qualified health benefit plans through newly established health insurance exchanges begins in October of this year. To be eligible for the tax credit as early as Jan. 1, 2014 -- when all citizens are required to have minimum essential health coverage -- it's important to file your 2012 tax return.
The premium assistance tax credit is available on a sliding scale basis for individuals (single or joint filers) with household incomes between 100 and 400 percent of the federal poverty level who do not receive health insurance through an employer or a spouse's employer, according to a technical explanation document prepared by staff of the Joint Committee on Taxation.
People who qualify can take the tax credit in the form of advance payments to lower their monthly health plan premiums starting in 2014, states information on healthcare.gov. The tax credit will be sent directly to the insurance company and applied to premium payments.
To determine eligibility for the tax credit, "exchange participants must provide information from their tax return from two years prior during the open enrollment period for coverage during the next calendar year," the technical explanation document states. "For example, if an individual applies for a premium assistance credit for 2014, the individual must provide a tax return from 2012 during the 2013 open enrollment period."
Regulations developed last year allow health insurance exchanges to obtain income information for eligibility determinations from the Internal Revenue Service. However, the Affordable Care Act requires exchanges to use alternative means to verify income if information is not available from the IRS.
Under federal tax laws, not everyone is required to file an annual tax return. Whether you must file a return depends on your gross income, filing status and age. For example, according to the website 1040.com, a single person younger than 65 does not have to file a return if gross income for 2012 was below $9,750. That's below the 2012 federal poverty guideline of $11,170 for a single-person household.
The Affordable Care Act requires all Americans to have minimum essential coverage or pay a tax penalty, but there are exemptions from the penalty for persons with income at the poverty level or below or persons for whom health insurance costs would be more than 8 percent of household income.
In addition to future health insurance tax credit eligibility determinations, however, there are other incentives for low-income taxpayers to file a tax return, said Mark Hanson, an IRS spokesman in North Carolina.
"That is the only way to get a refund they may be entitled (to) if they had a job and had taxes withheld during the year," Hanson said.
In addition, taxpayers who earned below $51,000 in 2012 may be eligible for the Earned Income Tax Credit, Hanson noted. The maximum EITC this year could be up to about $5,900, while the average claimed last year was $2,200.
"Each year, about one out of five eligible taxpayers do not claim the credit, many because they simply do not file," he said.