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Obamacare tax forms in the time of coronavirus

VP Pence at White House meeting with Trump on coronavirus 10March2020
Vice President Mike Pence, left, discusses COVID-19 testing following a White House meeting with Donald J. Trump and health insurance executives on Tuesday, March 10. (Screenshot from The Hill coverage)

The hubby and I get an annual flu shot. We also, after consulting with our health insurance, got the new two-part shingles vaccine last year.

That part about talking with our insurer was key. We had received the older shingles vaccination years earlier. We wanted to make sure that didn't preclude the subsequent shots, which are supposed to be more effective.

We were pleased to learn that the new shot sequence was covered. Even better, it was covered in full.

Coronavirus test coverage: I thought of that when Vice President Mike Pence, who's heading the Trump Administration's coronavirus task force, today announced that tests for COVID-19 would be covered by all health insurance policies.

"I'm pleased to report that … all the insurance companies here, either today, or before today, have agreed to waive all copays on coronavirus testing, and extend coverage for coronavirus treatment in all of their benefit plans," Pence announced following a White House meeting with the executive leaders of major health insurance companies.

The hope is that the ability to be tested and, if the results show any infection, quickly treated, that the panic about the coronavirus will abate somewhat.

This latest health declaration follows Pence's statement last week that the Department of Health and Human Services has designated the coronavirus test as an essential health benefit (EHB).

"That means, by definition, it’s covered in the private health insurance of every American, as well as covered by Medicare and Medicaid," Pence said during a March 4 press briefing on the outbreak.

Invoking while fighting Obamacare: An interesting thing about that earlier statement was Pence's use of the phrase "essential health benefit." That's straight out of the Affordable Care Act, still known as Obamacare.

The ACA requires insurance plans for individuals and small employers to provide coverage of 10 essential health benefits. These include prescription drugs, maternity care, hospitalization and laboratory services. That lab work could include diagnostic tests for, say, influenza, strep throat or coronavirus.

Ironically, the Trump Administration and Republicans on Capitol Hill are continuing their quest to kill the ACA. This Administration and 18 Republican state attorneys general asked the Supreme Court to deem Obamacare unconstitutional.

On March 2, the nation's highest judicial panel agreed to hear the case. Oral arguments are expected this fall, with the justices issuing a decision next spring.

But in talking about the COVID-19 crisis, the Trump Administration is invoking at least a part of the ACA. It's true. Politics and health crises do indeed make strange bedfellows.

ACA forms still in place: It's also a reminder to us that for now, the ACA is still the law. And that means that some tax-related forms are still in force. These forms are featured on today's Tax Form Tuesday.

The TCJA still requires for the 2018 tax year that taxpayers report their coverage or qualify for an exemption in order to avoid the tax, officially known as the individual shared responsibility payment.

  • Form 1095-A, Health Insurance Marketplace Statement
    You'll get this form if you got your health care coverage through the Marketplace. In these cases, you may qualify for a tax help via the premium tax credit, which you'll claim when you file your return on Form 8962 using the data on your 1095-A. If you received advance health care coverage payments made on your behalf, you'll use the 1095-A info and 8962 to reconcile those amounts when you file.

Form 1095-A marketplace coverage form excerpt

This form has the coverage details, who is insured under the policy and breaks it down on a monthly basis. That's because the penalty, when it was in effect, applied to each month that you didn't have the ACA-adequate coverage.

  • Form 8962, Premium Tax Credit (PTC)
    The PTC is the tax subsidy some purchasers of health insurance get to help pay for their policies. You'll use the information from your 1095-A to claim the credit if you paid for your coverage on your own or to reconcile an advance PTC payment you got to cover your policy's premiums.

No penalty, but 1095-A still important
The Tax Cuts and Jobs Act (TCJA) removed 
the ACA's tax penalty for not having health insurance.

Technically, the Obamacare mandate that we all have
some sort of minimally acceptable insurance still exists. 
But the tax reform law says if we opt not to,
we no longer must pay a tax price for that choice. 

Since the coverage mandate officially is still in effect,
if you get coverage through the Marketplace
you'll still get a 1095-A detailing that insurance.

Again, if you're eligible for the Premium Tax Credit (PTC),
either claiming it when you file or reconciling advance payments,
both of which are done by filing Form 8962,
you'll need that data on Form 1095-A.

Also note that while the federal no-insurance penalty is,
for now, history, some states still impose penalties
on their residents who do not have health care coverage.
That's the case in California, Massachusetts,
New Jersey and Rhode Island.


  • Form 1095-B, Health Coverage
    Health insurance providers, for example, health insurance companies, will send Form 1095-B to individuals they cover. This form shows who was covered and when.

  • Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
    Certain employers will send Form 1095-C to certain employees, with information about what coverage the employer offered.

As for Forms 1095-B and C, the Internal Revenue Service is enforcing the still-on-the-federal-books employer mandate of Obamacare. That's why you'll get, depending on how your get your private medical insurance and/or your employer's size, one of these forms.

However, since the minimum essential coverage penalty, known officially as the individual shared responsibility payment, no longer applies thanks to the TCJA, you don't have to report this 1095-B or 1095-C coverage on your Form 1040. 

The information on these B and C forms also could affect your or your family members' eligibility for the Premium Tax Credit. So look for these documents, even if you don't have to use the data.

You also don't need to file any of the 1095 forms with your return. Just use the information from them to complete, as applicable, your taxes — and PTC claim or reconciliation — and then keep the forms with your tax records.

You can find more on each of these documents and other ACA related forms at the IRS' online questions and answers page about the various 1095 forms.

And when it comes to the coronavirus, if you and your doctor feel you need to take the VP-announced covered test, do it. Take care of yourselves and stay safe, people! 

Coronavirus COVID-19 CDC image

 

Coronavirus Caveat & More Information
In 2020, we're all dealing with extraordinary circumstances,
both in our daily lives and when it comes to our taxes.
The COVID-19 pandemic and efforts to reduce its transmission
and protect ourselves and our families means that,
for the most part, we're focusing on just getting through these trying days.

But life as we knew it before the coronavirus will return,
along with our mundane tax matters.
Here's hoping that happens soon!
In the meantime, you can find more on the virus and its effects on our taxes
by clicking Coronavirus (COVID-19) and Taxes.

 

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