Vernoia, Enterline + Brewer, CPA LLC

When Congress passed the Patient Protection and Affordable Care Act and its companion bill, the Health Care and Education Reconciliation Act (collectively known as the Affordable Care Act) in 2010, lawmakers staggered the effective dates of various provisions.  The most well-known provision, the so-called individual mandate, is scheduled to take effect in 2014.  A number of other provisions are scheduled to take effect in 2013. All of these require careful planning before their effective dates.

2013

Two important changes to the Medicare tax are scheduled for 2013.  For tax years beginning after December 31, 2012, an additional 0.9 percent Medicare tax is imposed on individuals with wages/self-employment income in excess of $200,000 ($250,000 in the case of a joint return and $125,000 in the case of a married taxpayer filing separately). Moreover, and also effective for tax years beginning after December 31, 2012, a 3.8 percent Medicare tax is imposed on the lesser of an individual’s net investment income for the tax year or modified adjusted gross income in excess of $200,000 ($250,000 in the case of a joint return and $125,000 in the case of a married taxpayer filing separately).

The Affordable Care Act sets out the basic parameters of the new Medicare taxes but the details will be supplied by the IRS in regulations.  To date, the IRS has not issued regulations or other official guidance about the new Medicare taxes (although the IRS did post some general frequently asked questions about the Affordable Care Act’s changes to Medicare on its web site).   As soon as the IRS issues regulations or other official guidance, our office will advise you. In the meantime, please contact our office if you have any questions about the new Medicare taxes.

Also in 2013, the Affordable Care Act limits annual salary reduction contributions to a health flexible spending arrangement (health FSA) under a cafeteria plan to $2,500.  If the plan would allow salary reductions in excess of $2,500, the employee will be subject to tax on distributions from the health FSA.  The $2,500 amount will be adjusted for inflation after 2013.

Additionally, the Affordable Care Act also increases the medical expense deduction threshold in 2013.  Under current law, the threshold to claim an itemized deduction for unreimbursed medical expenses is 7.5 percent of adjusted gross income.  Effective for tax years beginning after December 31, 2012, the threshold will be 10 percent.  However, the Affordable Care Act temporarily exempts individuals age 65 and older from the increase.

2014

The Affordable Care Act’s individual mandate generally requires individuals to make a shared responsibility payment if they do not carry minimum essential health insurance for themselves and their dependents.  The requirement begins in 2014.

To understand who is covered by the individual mandate, it is easier to describe who is excluded.  Generally, individuals who have employer-provided health insurance coverage are excluded, so long as that coverage is deemed minimum essential coverage and is affordable.  If the coverage is treated as not affordable, the employee could qualify for a tax credit to help offset the cost of coverage.  Individuals covered by Medicare and Medicaid also are excluded from the individual mandate.  Additionally, undocumented aliens, incarcerated persons, individuals with a religious conscience exemption, and people who have short lapses of minimum essential coverage are excluded from the individual mandate.

The individual mandate was at the heart of the legal challenges to the Affordable Care Act after its passage.  These legal challenges reached the U.S. Supreme Court, which in June 2012, held that the individual mandate is a valid exercise of Congress’ taxing power.

Like the new Medicare taxes, the Affordable Care Act sets out the parameters of the individual mandate.  The IRS is expected to issue regulations and other official guidance before 2014.  Our office will keep you posted of developments.

2014 will also bring a new shared responsibility payment for employers.  Large employers (generally employers with 50 or more full-time employees but subject to certain limitations) will be liable for a penalty if they fail to offer employees the opportunity to enroll in minimum essential coverage.  Large employers may also be subject to a penalty if they offer coverage but one or more employees receive a premium assistance tax credit.

The employer shared responsibility payment provisions are among the most complex in the Affordable Care Act.  The IRS has requested comments from employers on how to implement the provisions.  In good news for employers, the IRS has indicated may develop a safe harbor to help clarify who is a full-time employee for purposes of the employer shared responsibility payment.

If you have any questions about the provisions in the Affordable Care Act we have discussed, please contact our office at (908) 725-4414.

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