The Affordable Care Act (aka “the ACA”) has been with us for over 8 years, and there remains confusion about some of the key provisions. It hasn’t helped that there have been repeated legislative efforts to repeal the law entirely, or at least poke holes in key provisions. The result of this confusion coupled with uncertainty about perceived changes to the law has led to a lot of misinformation about the status of the ACA. Let’s take a look at a few of the more prevalent current misconceptions about the ACA – what is fact and what is fiction? The ACA was Ruled Unconstitutional by a Texas Judge in 2018 TRUETRUE TRUE. However, the ruling has no immediate effect on the ACA and an appeal is presently working its way through the courts. It is widely expected that the case will be overturned in the appellate court, and possibly the Supreme Court if it gets that far, and most experts agree the case has no merit. The Individual Mandate was Repealed FALSE. The mandate for individuals to have health insurance remains in the tax code, however the penalty was reduced to “zero”. This change was part of the tax reform bill signed by President Trump in 2018 and effectively makes the individual mandate unenforceable by the IRS. But there is nothing to prevent a future Congress from reinstating the penalty value.
The Employer Mandate was Repealed
FALSE. The large employer mandate to offer affordable coverage to full time employees remains in full force and effect. Nothing has changed here.
1094-C/1095-C Reporting is No Longer Required
FALSE. Annual informational reporting required by the IRS by way of Forms 1094-C and 1095-C remains a compliance issue for employers. There has been an argument presented that with the change in the enforcement of the individual mandate makes this reporting is no longer necessary. However, to date, the IRS has made no change to this regulation. ACA reporting continues to be required.
California May Implement a State-Based Individual Mandate
TRUETRUE TRUE. With the elimination of enforcement of the ACA individual mandate on the federal level, many states are considering implementing state-based mandates. Several states have already passed such laws, and California is likely to be next.
The IRS is Not Collecting ACA Penalties from Employers FALSE. Employers across the country have been receiving Letter 226J from the IRS – proposed Employer Shared Responsibility Payment (ESRP) – as of reporting year 2015, and the notices continue to be issued as of this writing. The IRS is currently enforcing employer mandate penalties for reporting year 2016, and they will continue with this enforcement for as long as the employer mandate is in place.
Article Credit: Employee Benefits Corporation: Keith Dunlop