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Obama's Healthcare Windfall: the Penalty Stage

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  • Obama's Healthcare Windfall: the Penalty Stage

    Affordable Care Act’s Tax Effects Now Loom for Filers
    DEC. 25, 2014

    If you decided to skip health insurance this year, consider this: Unless you can prove you have a valid excuse, you will be liable for a penalty during the coming tax season — and the time to start making your case is now.

    That’s not all. People who bought subsidized insurance through one of the marketplaces may have new tax forms to complete, while paying the penalty itself may demand some serious number-crunching.

    The Internal Revenue Service is gearing up to answer questions, but it warns that only half of the callers may get through — and those who succeed may have to wait a half-hour or more.

    “There are quite a number of moving parts that taxpayers have not had to deal with,” said Kristin Esposito, technical tax manager for the American Institute of Certified Public Accountants.

    The Obama administration’s Affordable Care Act — including its penalty provision — is in effect for the first time this year and will be reconciled through a person’s tax return.

    Paying the penalty may also deliver some surprises. People who were uninsured for more than three consecutive months may owe something. (And since the penalty will double next year, now is the time to determine how much that might cost, before it is too late to buy a health policy through a federal or state-run marketplace for 2015.)

    “This is a learning experience for everyone involved,” said Roberton Williams, a senior fellow at the Tax Policy Center.

    “When you combine that with all of the problems with the exchanges, there will be a lot of confusion and people will be sorting it out. I am sure the I.R.S. will be inundated with calls.”

    But be prepared to hit redial. John Koskinen, the Internal Revenue Service commissioner, admitted in a recent speech that because of budget constraints, the agency may be equipped to answer just over half of the phone calls it receives. Many will get a “courtesy disconnect.”

    EXEMPTIONS Consumer advocates said they were concerned that some taxpayers might not realize that they needed to apply for certain exemptions, and, in some cases, substantiate their circumstances. (An estimated 23 million people will qualify for an exemption in 2016, while many others will be granted a pass because of a hardship, according to a federal analysis.)

    Once an exemption is approved (and if it’s not, the applicant can appeal), a taxpayer is sent an “exemption certificate number,” which should be entered on the tax return.

    PENALTIES Uninsured people who cannot qualify for an exemption will be required to pay a penalty, also known as the individual shared responsibility payment. Even people who went without insurance for more than three months may have to pay something.

    The penalties will rise sharply over the next couple of years, so taxpayers contemplating paying the penalty instead of buying insurance for the coming year should run those calculations soon: Open enrollment on the health care exchanges runs from Nov. 15 to Feb. 15.

    For the 2014 tax year, individuals pay whichever is more: $95 or 1 percent of the portion of their modified adjusted gross income that exceeds the federal income tax filing threshold: $10,150, for example, for those with single filing status. But payments are calculated on a monthly basis for each household member.

    Those figures are about to double. A family of four earning $100,000 who skipped coverage in the last year would owe just shy of $800 in 2014, but it would need to pay nearly $1,650 in 2015, according to the Tax Policy Center’s calculator, which can determine how much a taxpayer might pay.

    There is some question about how aggressive the I.R.S. will be in collecting the penalty in its first year.

    RECONCILING People who bought subsidized insurance on the exchanges received what is actually an advance on a tax credit. Since the amount of help taxpayers received was based on 2012 income, it will need to be reconciled against what they actually earned in 2014 — particularly if they earned more or less and did not update their income data on the exchange.

    Some people will be surprised that they must pay some of that money back, or at least have it deducted from what they would have received in a refund. Conversely, people who earned less money in 2014 — and who received subsidies that were too small — may receive money back. Changes in life circumstances — a divorce, marriage, a new child — can also affect those numbers.

    “This is the part that can be very complex,” said Kathy Pickering, executive director of the Tax Institute at H&R Block. “People think of the tax credit as a discount on their premium. But realizing it can be something you repay a portion of is going to be a surprise.”

  • #2
    Re: Obama's Healthcare Windfall: the Penalty Stage

    Will this be the thing that actually wakes the sheeple up from their sleep? Or will they rouse, yawn a bit, and close their eyes once again?
    Last edited by charliebrown; December 27, 2014, 09:53 AM.

    Comment


    • #3
      Re: Obama's Healthcare Windfall: the Penalty Stage

      My work claims my insurance costs over 20K per year for me and my family. If I did not have a job for a big company, $1,650 might make sense to avoid such a large expense. And, the way they describe it, I am helping poor people at the same time. I feel warm and fuzzy.

      We all knew it is coming. We will adjust to higher taxes as we have always done.

      Comment


      • #4
        Re: Obama's Healthcare Windfall: the Penalty Stage

        Originally posted by aaron View Post
        My work claims my insurance costs over 20K per year for me and my family. If I did not have a job for a big company, $1,650 might make sense to avoid such a large expense. And, the way they describe it, I am helping poor people at the same time. I feel warm and fuzzy.

        We all knew it is coming. We will adjust to higher taxes as we have always done.
        Maybe Airbnb can help.

        Comment


        • #5
          Re: Obama's Healthcare Windfall: the Penalty Stage

          To me the funny thing is one of the ideas used to sell the healthcare act is that it would spur the economy because people wouldn't be tied to the insurance plans of their current employers, meaning, they would be able to buy healthcare elsewhere.

          I have had a business opportunity presented to me that would require I leave my current place of employment. Given the crazy cost increases I've heard of from friends who purchase on the open market since Obamacare went into effect, the uncertainty alone of giving up a sure thing as far as health care for me and my family is giving me cold feet from thinking the marketplace is something I can predict with any certainty.

          I need to assume that whatever I might presently be able to afford, I've got to assume double digit increases via the open market or exchanges? That's crazy. I actually will see a decrease in my premium in 2015 with my current job!

          I'm still going to pursue the opportunity, just need my wife to take aggressive steps to find a job with reliable coverage.
          Last edited by wayiwalk; December 29, 2014, 12:45 PM.

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          • #6
            Re: Obama's Healthcare Windfall: the Penalty Stage

            Health Care Law Spurs Merger Talks for Insurers


            President Obama signed the Affordable Care Act more than five years ago. At the time, members of the health care industry — hospitals, doctors and insurers — were anxious about what it would do to the business. Everyone had an opinion, but nobody knew for sure.

            We’re now beginning to see the answer: consolidation on a huge scale.

            Just in the last couple of weeks, the nation’s five largest health insurers began a round robin of merger talks — some still semiprivate, others now out in the open — that could whittle their number to three. Anthem made a bid for Cigna; Aetna approached Humana; and the UnitedHealth Group made overtures to Aetna.

            Those potential deals come on the heels of a spate of hospital mergers over the last couple of years — and speculation about another round of such deals.

            All of this deal-making is largely the result of the Affordable Care Act, which in effect constrains the amount of profit hospitals and insurers can generate, leading both to seek additional scale in hopes of generating higher margins by squeezing additional savings out of a broader customer base.

            To some degree, consolidation among hospitals and insurers was part of the design of the law, which sought to provide health care for the uninsured and help push down health care costs. That led health care companies to find efficiencies. That, in turn, meant deals.

            In 2011, the Aetna chief executive, Mark T. Bertolini, responded matter-of-factly to an analyst’s question about possible mergers: “I expect and we expect that consolidation will continue going forward here as health reform shakes out winners and losers in the process.”

            The question, of course, remains whether the savings that might come from consolidation will trickle down to the consumer or will simply wind up in the pocket of shareholders.

            The prevailing view is not promising.

            “Seldom does consolidation result in reduced costs for consumers. Bigger insurance companies mean increased leverage and unfair power over negotiating rates with hospitals and physicians,” the American Academy of Family Physicians wrote in a letter earlier this month to the Federal Trade Commission, urging that it block the latest series of deals. “More often than not, consolidation increases costs and reduces options for consumers, and we believe this would hold true in the health insurance market.”

            Perhaps more striking, Cigna, in its rejection of Anthem’s $47 billion takeover bid, cited the risk of antitrust suits that have ensnared Anthem as the largest member of the Blue Cross Blue Shield Association. That association has been accused of cartel-like practices, deliberately preventing competition so as to increase prices for hospitals and patients.

            Cigna’s rejection of Anthem and its highlighting of antitrust risks, just to be clear, was not aimed at ending merger talks. Oddly enough, people involved in the negotiations suggested it was simply a tactic to press Anthem to pay more, in part to compensate Cigna shareholders for the possibility that a deal could be blocked.

            Of course, regulators will most likely look hard at any large deals among insurers. But it would be ironic if the administration, after helping to get the law passed with the support of the insurance industry, then prevented insurers from merging.

            So far, regulators have looked favorably at big hospital mergers, persuaded by the efficiencies argument.

            “The fear that mergers curtail competition, leading to higher prices for medical care, reflects an old way of thinking that doesn’t account for the introduction of population-health management,” Dr. Kenneth L. Davis, the chief executive of Mount Sinai Health System, wrote persuasively in The Wall Street Journal. “This line of thought ignores the fact that health care delivery has become more efficient. Health care has changed, too: Medical advances mean that people recover from serious illness and injury faster and live longer, healthier lives.”

            Nonetheless, regulators would have good reason to consider ways to try to maintain competition among the largest insurers.

            In one of the few studies conducted on the impact of consolidation in the insurance industry on premiums, academics looked at the effect of the 2007 merger of the UnitedHealth Group and Sierra Health Services on consumers in Nevada.

            The results were striking. “If there were any benefits to consumers realized from the merger, we could not observe them, and we can infer that they did not come in the form of lower premiums,” the authors wrote in the journal Health Management, Policy and Innovation. “On the contrary, the evidence suggests that large health insurer mergers are anticompetitive and cause injury to consumers through an increase in the price of health insurance services.”

            The authors said that they found “premiums in Nevada markets increased by 13.7 percent after the merger relative to the control group.”

            They added, “Our findings suggest that the merging parties exploited the market power gained from the merger.”

            Based on the high-flying stock prices of the big health insurers right now, investors must be convinced that bigger profits are in the offing. The chief executives are also expecting big paydays.

            Virtually every one of them has planned large golden parachutes in anticipation that their companies could be taken over. According to data compiled by Bloomberg, Mr. Bertolini of Aetna stands to make $131.3 million in a takeover if he were pushed out; David Cordani of Cigna would make $58.7 million; and Bruce D. Broussard of Humana would receive $26.1 million.

            Mr. Bertolini was probably right about winners and losers. The big health insurers could win. Their shareholders could win. Their executives could win. On the other side, however, may very well be the consumers.

            In short, let the market decide . . .

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            • #7
              Re: Obama's Healthcare Windfall: the Penalty Stage


              In short, let the market decide . . .


              Facilitating monopolies is hardly "letting the market decide".
              It's just more rigging of the game as in other sectors of our once great economy.

              PelosiCare (ObamaCare) was a pile of putrid crap from its inception. The biggest patsies of Jonathan the Gruber are the brilliant twenty-something crowd who are going to be royally screwed, along with most other Americans. There was no real attempt at cost control.

              I have zero experience in healthcare management, hospital or clinic administration or otherwise, but my nephew who has seven years worth - and a Masters Degree in the field - could have done a better job of drafting a solution to many of the problems than the Democrats did. For one thing: you don't let the insurance companies "help you" write the legislation!

              Comment


              • #8
                Re: Obama's Healthcare Windfall: the Penalty Stage

                Yes, Raz, the mantra "let the market decide" in a century of concentration, monopoly and oligarchy is a joke.

                Comment


                • #9
                  Re: Obama's Healthcare Windfall: the Penalty Stage

                  Originally posted by don View Post
                  Yes, Raz, the mantra "let the market decide" in a century of concentration, monopoly and oligarchy is a joke.
                  Even at the micro level, letting the market decide leads to ridiculously inefficient outcomes. Like that corrupt FIFA exec turned rat that was blowing $6,000 per month on a 5th Avenue luxury apartment in NYC for his cats. Meanwhile, the people who clean the cat turds out of the place have to bus themselves in from New Jersey.

                  Almost any other conceivable use of America's very limited quantity of prime Manhattan real estate would be more efficient than an opulently furnished, marble-floored cat palace.

                  It's a prime example of "letting the market decide" leading to the absolutely least efficient and dumbest use of scarce resources imaginable.

                  Comment


                  • #10
                    Re: Obama's Healthcare Windfall: the Penalty Stage

                    Originally posted by dcarrigg View Post
                    Even at the micro level, letting the market decide leads to ridiculously inefficient outcomes. Like that corrupt FIFA exec turned rat that was blowing $6,000 per month on a 5th Avenue luxury apartment in NYC for his cats. Meanwhile, the people who clean the cat turds out of the place have to bus themselves in from New Jersey.

                    Almost any other conceivable use of America's very limited quantity of prime Manhattan real estate would be more efficient than an opulently furnished, marble-floored cat palace.

                    It's a prime example of "letting the market decide" leading to the absolutely least efficient and dumbest use of scarce resources imaginable.
                    Could you please explain how corrupt behavior from a heavily subsidized entitled NGO bureaucrat has anything to do with a genuinely free market that is subject to the enforcement of a "level playing field?"
                    "I love a dog, he does nothing for political reasons." --Will Rogers

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                    • #11
                      Re: Obama's Healthcare Windfall: the Penalty Stage

                      Like your pun with the rat and the cats. Is it just me or are real news stories reading more and more like something from "The Onion?"
                      "I love a dog, he does nothing for political reasons." --Will Rogers

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                      • #12
                        Re: Obama's Healthcare Windfall: the Penalty Stage

                        When was the last time "a genuinely free market" was the dominant characteristic of our economy? This longing for a 'free market', which inevitably leads to a monopolistic economy, ignores history, both in the macro and in the micro.

                        Comment


                        • #13
                          Re: Obama's Healthcare Windfall: the Penalty Stage

                          Originally posted by don View Post
                          When was the last time "a genuinely free market" was the dominant characteristic of our economy? This longing for a 'free market', which inevitably leads to a monopolistic economy, ignores history, both in the macro and in the micro.
                          Enlighten me on how the Affordable Care Act changes this tendency towards monopoly in the health care and insurance fields.

                          Comment


                          • #14
                            Re: Obama's Healthcare Windfall: the Penalty Stage

                            Originally posted by LorenS View Post
                            Enlighten me on how the Affordable Care Act changes this tendency towards monopoly in the health care and insurance fields.
                            It doesn't.

                            Comment


                            • #15
                              Re: Obama's Healthcare Windfall: the Penalty Stage

                              Originally posted by photon555 View Post
                              Like your pun with the rat and the cats. Is it just me or are real news stories reading more and more like something from "The Onion?"
                              The problem is that all shame is gone. They're licensing "naturopathic doctors" in something like 20 states now, and in some they have full prescribing rights. We've literally brought back the witch doctor in law. I figure if you can make it popular enough, you ought to be able to bring back leeches and blood letting too.

                              Oops. Wait. They're already doing that...

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