scholarly journals Personal Federal Tax Issues And The Affordable Care Act: Can Tax Penalties And Subsidized Premiums Provide Sufficient Incentives For Health Insurance Purchases

2013 ◽  
Vol 11 (7) ◽  
pp. 315
Author(s):  
Alan D. Eastman ◽  
Kevin L. Eastman
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Tax Credits ◽  
Medical Expenses ◽  
Patient Protection ◽  
Tax Cost ◽  
The Supreme Court ◽  
Gross Income ◽  
The Cost ◽  
Threshold Amount

The Patient Protection and Affordable Care Act of 2010 (ACA) includes many changes to the U.S. Federal Tax Code. The tax penalty imposed on individuals who choose to remain uninsured received extraordinary attention while the Supreme Court determined the constitutionality of the ACA. Now, the more relevant question is what impact the penalty may have on individual behavior. This paper presents information that suggests the tax penalty may provide insufficient incentive for many individuals to purchase insurance, even with premium tax credits to reduce the cost for households earning up to 400% of the federal poverty limit. The ACA also reduces the tax benefit from themedical expense deduction by increasing the threshold amount from 7.5% of adjusted gross income to 10% of adjusted gross income. This may increase the after-tax cost of purchasing health insurance, especially for healthier individuals whose medical expenses (excluding insurance premiums) are below the threshold amount, increasing the incentive to forego the purchase of health insurance and to pay the penalty instead. An approach more consistent with the aims of the ACA is to eliminate the threshold amount but limit the deduction to lower-income taxpayers.

scholarly journals Using Behavioral Economics to Understand Premium Tax Credit Reconciliation

2016 ◽  
Vol 23 ◽  
pp. 1
Author(s):  
Sarah Baggé
Keyword(s):  
Health Insurance ◽  
Behavioral Economics ◽  
Affordable Care Act ◽  
Private Health Insurance ◽  
Tax Credits ◽  
First Year ◽  
Tax Credit ◽  
Cognitive Influences ◽  
The Cost ◽  
Reconciliation Process

The Affordable Care Act provides advanced premium tax credits to millions of Americans to help with the cost of purchasing private health insurance on the new health insurance marketplaces. The amount of subsidy a family qualifies for is based on their projected income for the year ahead. However, since income is fairly unpredictable, some families end up qualifying for a larger tax credit when they do their taxes, while others end up with a smaller credit and must repay what they received throughout the year. In the first year of this reconciliation process, half of those who received advanced premium tax credits had to pay at least a part back. This outcome is consistent with recent literature in behavioral economics, which explores psychological, social, and cognitive influences on decision-making. This paper explores the reconciliation problem and possible approaches to reducing or eliminating it.

Did the time frame associated with the implementation of the Patient Protection and Affordable Care Act noticeably impact consumer bankruptcy filings?

2017 ◽  
Vol 44 (12) ◽  
pp. 1957-1972
Author(s):  
Donald D. Hackney ◽  
Daniel Friesner ◽  
Erica H. Johnson
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Dynamic Change ◽  
Time Frame ◽  
Insurance Premium ◽  
Skewed Distribution ◽  
Structural Dynamic ◽  
Content Type ◽  
Patient Protection ◽  
The Impact

Purpose The purpose of this paper is to examine whether the timing associated with the implementation of the health insurance-related provisions of the Patient Protection and Affordable Care Act (ACA) altered the presence and distribution of medical/non-medical debts accumulated by different types of bankruptcy filers. Design/methodology/approach Data were drawn from the US Bankruptcy Court’s Eastern Washington District over the years 2009, 2011 and 2014 using interval random sampling. Binary probit and Tobit analyses were used to model the existence, and distribution, of medical debts and total debts, respectively, at the time of filing. The impact of the time frame associated with the ACA was operationalized via a Chow test for structural dynamic change. Findings Chapter 13 filers in 2014 (post-ACA-based health exchange implementation) were more likely to report medical debts than Chapter 7 filers in the pre-intervention period, and were also more likely to report a larger proportion of outstanding debts owed to a single creditor. Filers claiming health insurance premium expenses in 2011 were (at the 10 percent significance level) more likely to report a more skewed distribution of medical debts. Originality/value The time frame associated with the implementation of the ACA impacts the distribution of medical debts among filers who have sufficient net disposable income to fund a Chapter 13 plan. The polarization of outstanding medical debts may indicate coverage gaps in existing health insurance policies, whose costs would be disproportionately borne by patients operating on thin financial margins.

scholarly journals Increasing Health Insurance Coverage through an Extended Federal Employees Health Benefits Program

2001 ◽  
Vol 38 (2) ◽  
pp. 177-192 ◽  
Author(s):  
Beth C. Fuchs
Keyword(s):  
Health Insurance ◽  
High Risk ◽  
Small Firms ◽  
Insurance Coverage ◽  
Health Benefits ◽  
Health Insurance Coverage ◽  
Tax Credits ◽  
Federal Employees ◽  
Public Programs ◽  
The Cost

The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or “E-FEHBP,” would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable.

scholarly journals A FEW FOR-PROFIT BUSINESSES’ BATTLE OVER THE AFFORDABLE CARE ACT’S PREVENTATIVE SERVICES MANDATE

2014 ◽  
Vol 32 (2) ◽  
pp. 381-400
Author(s):  
Leigh Argentieri Coogan
Keyword(s):  
Affordable Care Act ◽  
Cost Sharing ◽  
Religious Organizations ◽  
District Court ◽  
Health Plans ◽  
For Profit ◽  
Patient Protection ◽  
The Supreme Court ◽  
Regulation Changes ◽  
Preventative Services

Under the Patient Protection and Affordable Care Act (ACA), employers are required to provide employees with health plans, which must include FDA, approved contraceptives with no cost sharing. While Health and Humans Services (HHS) revised the regulation to allow for a compromise among religious organizations and non-profits run by religious organizations, private for profit businesses must comply with the ACA even if the business asserts to be founded on religious principles. Several for profit business have sued in district court for an injunction against the requirements. However, a circuit split exists among courts granting preliminary injunctions against the ACA pending a granting of appeal. This note will focus on whether the federal government can compel secular, for profit organizations to provide employee health plans that include contraceptives, the morning after pill and sterilization under the Religious Freedom Restoration Act. Unless the statute or regulation changes, the Supreme Court will likely need to grant certiorari to resolve the issue.

scholarly journals Cost Analysis in Shoulder Arthroplasty Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Matthew J. Teusink ◽  
Nazeem A. Virani ◽  
John A. Polikandriotis ◽  
Mark A. Frankle
Keyword(s):  
Affordable Care Act ◽  
Shoulder Arthroplasty ◽  
Accountable Care Organizations ◽  
Accountable Care ◽  
Bundled Payment ◽  
Patient Protection ◽  
Episode Of Care ◽  
The Cost ◽  
Arthroplasty Surgery ◽  
Do So

Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs) and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

scholarly journals Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

2014 ◽  
Vol 104 (5) ◽  
pp. 329-335 ◽  
Author(s):  
Nicole Maestas ◽  
Kathleen J. Mullen ◽  
Alexander Strand
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Disability Insurance ◽  
Health Insurance Coverage ◽  
Insurance Reform ◽  
Health Insurance Reform ◽  
Access To Health ◽  
Social Security Disability ◽  
The Cost

As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)—potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset —will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals who otherwise lacked access to health insurance. We study the 2006 Massachusetts health insurance reform to estimate the potential effects of the ACA on SSDI and SSI applications.

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