ObamaCare & Taxes: How Life Changes Can Impact Your Premium Tax Credit - National Women's Law Center (2024)

  1. What kind of life changes could potentially impact my Premium Tax Credit?

The amount of your Premium Tax Credit is based on both the number of people in your household and your household income. Events that change your household size or income can change the amount of your Premium Tax Credit. Some examples of these types of changes include:

  • Giving birth
  • Adopting a child
  • Marriage
  • Divorce
  • A new job
  • Loss of a job

If you have any of these changes or any other change in household income or size at any point during the year, you need to update the Marketplace with that information as soon as possible, so that your Premium Tax Credit can be adjusted.

If your income goes down or your household size goes up during the year, you may be eligible for an increase in your Premium Tax Credit. If your income goes up or your household size goes down, you should report it so that your Premium Tax Credit amount can be lowered, limiting how much you may owe back when you file your taxes.

Life changes may also affect your eligibility for the Premium Tax Credit. If you become eligible for other health insurance, you are likely no longer eligible for the Premium Tax Credit. Eligibility for the Premium Tax Credit is based in part upon your ineligibility for other “minimum essential coverage”—including Medicare, Medicaid, or employer-sponsored health insurance that is considered adequate and affordable. For example, a new job may bring an offer of health insurance through your employer, making you ineligible for the Premium Tax Credit. If you become pregnant, you may become newly eligible for Medicaid during the pregnancy and postnatal period. So if at some point during the year, you receive an offer of health insurance through your employer, or you find out that you qualify for Medicaid or Medicare, you should update the Marketplace.

  1. If I have a change in household size or household income, when and how do I let the Marketplace know?

You should contact the Marketplace as soon as possible when your income or household size changes—including both increases and decreases. This way, your Premium Tax Credit amount can be adjusted to match your actual circ*mstances, and you can avoid either having to repay some of the credit you received, or missing out on a larger Premium Tax Credit to help you pay for health insurance throughout the year.

You will also likely qualify for a special enrollment period to adjust other aspects of your health insurance (but act quickly, because you only have 60 days from the date your income or household size changed to adjust your plan).

Visit https://www.healthcare.gov/how-do-i-report-life-changes-to-the-marketplace/ or call 1-800-318-2596 to report your changes to family status, employment, or income, and adjust your Premium Tax Credit today.

  1. What should I expect when I file my tax return in 2017?

If you received a Premium Tax Credit in 2016, you will report that on the tax return that you file in 2017. The health insurance Marketplace will send you a form with the amount of Premium Tax Credit you received during the year. The Marketplace will also provide information regarding your Premium Tax Credit to the IRS. When completing your tax return, you will use form 8962 to compare the total Premium Tax Credit you received to a final calculation based on your actual 2016 income (what you actually made) and household size.

How will this impact you? You could receive a tax refund (or if you owe taxes, have the amount that you owe reduced)—but you could end up paying back part of the Premium Tax Credit the Marketplace paid to your health insurer throughout 2016. This is why it is so important to update the Marketplace with any changes in income or household size that occur through the year— don’t wait until tax time!

  1. Do I have to do anything in particular when I file my tax return in 2017, if I received the Premium Tax Credit in 2016?

You will need to fill out a form 8962 to send with your tax return (the IRS is writing it as we speak). The Marketplace will send you an information statement on the Premium Tax Credit you receive in 2016 by January 31, 2017, which you will use to fill out your tax return and any related IRS forms.

In most cases, married couples who receive a Premium Tax Credit in 2016 are required to file a joint tax return, unless they are either legally separated OR meet very narrow requirements in order to file as Head of Household (lived apart from a spouse for the last 6 months of the year and paid half of the costs to maintain a household where a dependent child lives for over half the year). There is an exception for victims of domestic violence and spousal abandonment, when filing a joint return is impossible or dangerous.

ObamaCare & Taxes: How Life Changes Can Impact Your Premium Tax Credit - National Women's Law Center (2024)

FAQs

What changes could affect the amount of premium tax credit? ›

Changes in circ*mstances that can affect the amount of your actual Premium Tax Credit include: Increases or decreases in your household income. Events that could result in a significant increase to household income include: Lump sum payments of Social Security benefits, including Social Security Disability Insurance.

How does Obamacare affect my taxes? ›

A tax credit you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace®. Your tax credit is based on the income estimate and household information you put on your Marketplace application.

What disqualifies you from the premium tax credit? ›

To be eligible for the premium tax credit, your household income must be at least 100 percent and, for years other than 2021 and 2022, no more than 400 percent of the federal poverty line for your family size, although there are two exceptions for individuals with household income below 100 percent of the applicable ...

How much did taxes go up because of Obamacare? ›

Full List of Obamacare Tax Hikes
First $200,000 ($250,000 Married) Employer/EmployeeAll Remaining Wages Employer/Employee
Current Law1.45%/1.45% 2.9% self-employed1.45%/1.45% 2.9% self-employed
Obamacare Tax Hike1.45%/1.45% 2.9% self-employed1.45%/2.35% 3.8% self-employed

How to avoid repayment of premium tax credit? ›

How can I avoid it? The easiest way to avoid having to repay a credit is to update the marketplace when you have any life changes. Life changes influence your estimated household income, your family size, and your credit amount. So, the sooner you can update the marketplace, the better.

What happens to premium tax credit after 2025? ›

But the enhanced premium tax credits are set to expire after 2025. If Congress does not act, nearly all marketplace enrollees will face significantly higher premium costs and 3.8 million will become uninsured, according to Congressional Budget Office estimates.

What are the negative effects of Obamacare? ›

Cons:
  • The cost has not decreased for everyone. Those who do not qualify for subsidies may find marketplace health insurance plans unaffordable. ...
  • Loss of company-sponsored health plans. ...
  • Tax penalties. ...
  • Shrinking networks. ...
  • Shopping for coverage can be complicated.
Sep 29, 2021

Is Obamacare good or bad for the economy? ›

Estimates that the Affordable Care Act reduces the deficit by $143 billion seem reassuring, but only if we ignore the fact that we are shifting substantial new revenues from non-health care sources to meet new health care obligations – hardly ―bending the curve‖ by any plausible definition.

Do I have to pay back Obamacare tax credit? ›

If you received advance payments of the premium tax credit (APTC) for health insurance that you purchased last year on HealthCare.gov or a state-run health insurance Marketplace) and your income ended up increasing during that year, you might have to pay back some of your premium tax credit for health insurance.

What happens if I underestimate my income for Obamacare in 2024? ›

They will inquire about your tax return from the IRS and other databases. If you underestimated your income for that year and received a subsidy, you will need to pay the entire subsidy back the next time you file your taxes. You must report income changes to Covered California within 30 days.

What happens if my income increases while on Obamacare? ›

If your income goes up or your household size goes down, you should report it so that your Premium Tax Credit amount can be lowered, limiting how much you may owe back when you file your taxes.

What is the highest income to qualify for Obamacare in 2024? ›

The income range is $30,000 to $120,000 in 2024 for a family of four. (Income limits may be higher in Alaska and Hawaii because the federal poverty level is higher in those states.) The American Rescue Plan Act of 2021 also extended subsidy eligibility to some people earning more than 400% of the federal poverty level.

What happens if you don't use all of your premium tax credits? ›

If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit.

Is Obamacare a tax or penalty? ›

President Donald Trump signed the Tax Cuts and Jobs Act in 2017. This bill repealed the tax penalty mandate from the ACA. Therefore, Obamacare tax penalties are no longer in effect on a federal level as of 2019 and onwards. However, several states still mandate tax penalties for not having health insurance.

How to maximize premium tax credit? ›

If your income goes down or you gain a household member: You'll probably qualify for a bigger premium tax credit. You may want to increase the amount of tax credit you take in advance so you have a lower premium bill each month.

What factors determine the amount of your estimated premium tax credit? ›

To calculate the premium tax credit, the ACA marketplace will start by identifying the second-lowest cost silver plan that that is available to each member of the household, called the “benchmark plan.” The amount of the credit is equal to the total cost of the benchmark plan (or plans) that would cover the family ...

Why did my aptc go down? ›

Your APTC is calculated based on your estimated annual household income, household size and where you live. If your income or family size changes, this may impact the APTC you receive. Report changes to Covered California within 30 days of the change.

How do I adjust my premium tax credit? ›

You'll use IRS Form 8962 to do this. If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit.

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