New Healthcare Bill – Status Update
Anyone who read or watched any news coverage last week heard that the House of Representatives passed the “American Health Care Act” (AHCA), the New Healthcare Bill. This does not mean that the Affordable Care Act, aka Obamacare, has been repealed. Until the new healthcare bill, the AHCA, is passed by the Senate and signed by the President, the Affordable Care Act is the law and failing to comply with it exposes an employer to significant penalties.
The AHCA does not eliminate the ACA information reporting requirements; specifically the 1094/1095 Forms (B or C series) that employers and insurers began using to report Health Coverage and Offers of Health Coverage to the IRS.
WHAT THE AHCA DOES:
- Eliminates the tax penalty of the employer shared responsibility (aka “employer mandate”/“pay or play”) under the Affordable Care Act effective for tax years after 12/31/15.
- Eliminates the tax penalty of the individual shared responsibility effective for tax years after 12/31/15.
- Effective for Plan Year 2019 (2018 if special enrollment), it gives insurers the ability to impose a 30% surcharge on applicable premium rates, for a period of 12 months, for any individuals that have a lapse in coverage of 63 or more days.
- Delays the Cadillac tax until 2026, which eliminates the tax penalty for 2020 through 2025.
- Adds a field to Form W-2 to account for each month with respect to which an employee is eligible for a group plan.
- Raises the tax-free contribution limit on HSAs to match the out of pocket cost maximum on high-deductible health plans & adds other provisions to make HSAs more flexible.
- Replaces the Affordable Care Act’s exchange subsidies with a refundable tax credit tiered by age:
- $2k per year for anyone under age 30
- $2.5k per year for ages 30-39
- $3k per year for ages 40-49
- $3.5k per year for ages 50-59
- $4k per year for age 60 and over
Note: tax credit amount phases out for individuals with income over $75k (Joint filers, combined income over $150k). Tax credit is available for coverage in both the individual market and exchanges & for unsubsidized COBRA coverage (purchased on or off the exchanges). Tax credits are NOT available to individuals who are eligible for a group health plan (including employer sponsored coverage), Medicare, Medicaid or other government coverage.
- Eliminates the four standard levels of coverage plans (“metallic tiers”) that were required in the individual and small group markets under the Affordable Care Act.
- The annual insurance provider fee, the net investment income tax, and the medical device tax (and others) are all repealed beginning in 2017.
- For plan years that begin on or after 1/1/2018, states can apply to waive the AHCA’s age rating ratio of 5:1. (Note: It was 3:1 under the ACA.) States will be able to apply a higher ratio for age-based premium rating (higher than 5:1) in the individual and small group markets.
- For plan years that begin on or after 1/1/2020, states can apply to waive the essential health benefits (EHB) outlined by the ACA for individual and small group markets. States will be able to establish and apply their own EHB requirements.
- Beginning with 2019 enrollments, if a state has established an AHCA approved high risk pool program, the state can engage in health underwriting for individuals in the program who cannot demonstrate that they had continuous coverage over the prior 12 months (in lieu of the above referenced 30% surcharge for non-continuous coverage).
WHAT IT DOESN’T DO:
- Eliminate the ACA information reporting requirements.
- Does not cap the tax benefit for employer-sponsored health insurance coverage.
- Does not allow excess tax credits to be paid into designated HSAs.
You can read the new healthcare bill at this link: 115th Congress.
The Affordable Care Act has not been repealed, nor has it been replaced. The AHCA needs to be passed in the Senate and signed by the President before it becomes law.
ACA GPS has developed the ACA Management Tool® to assist employers (Large and Small) with achieving compliance with the ACA. We are authorized to transmit 1094/1095 B and C series forms for private businesses, government entities, and insurance companies.
ACA Management Tool® – Keeping you on TRACK with healthcare reform.
Contact us for information on 1094/1095 reporting: email@example.com
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