Tax Cuts and Jobs Act: Author Edition: Individual Mandate

With a document that’s 1,101 pages long, it can be hard to sift through to the “good stuff” (i.e., what will directly impact the average author). Here’s one piece: The removal of the individual mandate from the Affordable Care Act.

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What Was It Like Before? 

In case you missed it (please email me and let me know how you could have, as a citizen of the United State of America, missed any reference to the individual mandate because that is probably an amazing story), the individual mandate was a provision of the Affordable Care Act that penalized you at the end of the year if you had not had ‘approved’ health insurance for any number of months during the previous year.

For example, if you couldn’t afford to pay both your premium and your mortgage, you might have skipped on the insurance premium and gone without coverage for the last three months of the year. This would have resulted in you having a penalty assessed and multiplied by three months.

For some people, my younger brother was the example in my life, this wasn’t a big issue. He was being charged $220 for individual, catastrophic health insurance. However, since he is one of those people who never seems to need any medical treatment or hospitalization (Alien? Demi-god? Who knows!), he opted to not get coverage. He was penalized for it with a whopping…$300 fee. So, as most intelligent people would, he decided to keep $2,640 in his pocket throughout the year and just pay the measly $300 out of his tax return.

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What’s Going to Be Different? 

Under the Tax Cuts and Jobs Act (T’Caja? ^_^) this mandate will no longer be in force as of January 1st, 2019. This means that my brother could keep his main $2,640 AND not have to pay a $300 penalty for not purchasing something he didn’t want / need.

 

What Does This Mean For Us Specifically?

As authors, this means that we’ll need to prepare to shop around for insurance products that will protect us (and, indirectly, our family members) as well as fit our budget. Don’t just buy the first policy you come across. From what I’m hearing in my writing groups, some people have already been policy-shopping with the ACA, and others have not. Shopping policies is the only way to make sure you get the best possible deal.

My hunch is that, because people won’t be mandated to get insurance any more, there will be more of a push for insurance companies to provide competitive health insurance arrangements for individuals. So, pay attention to the prices now and compare them to prices this time next year and in the early months of 2019. Look for the cheapest coverage you can get that still protects you as you need to be protected. For us, this specifically means finding policies with affordable coverage for orthopedic and vision issues, such as carpal tunnel syndrome or eye exams, and offering incentives for doing things like losing weight (since writing is a sedentary activity).

It also means that, if you want coverage, you’re going to have to remember to get it. There won’t be a penalty hanging over your head any more. You will have to take the initiative to get out there, shop, and make a final purchase of a policy. If you’re like me, this can be difficult because our brains are going 10,000 miles a minute with thoughts ranging from cover design, to final scenes, to characters, and proposed release dates. I put reminders like this in my paper planner AND on my phone, just to be safe.

 

Where Is This Stuff? 

Page 153. I’ve copied the basic text for you below, but you can click this link to view the entire document yourself (including citations and references to other parts of the T’Caja)!

H. Elimination of Shared Responsibility Payment for Individuals
Failing to Maintain Minimal Essential Coverage
(sec. 11081 of the Senate amendment and sec. 5000A of the Code)

Present Law

Under the Patient Protection and Affordable Care Act352 (also called the Affordable Care
Act, or “ACA”), individuals must be covered by a health plan that provides at least minimum
essential coverage or be subject to a tax (also referred to as a penalty) for failure to maintain the
coverage (commonly referred to as the “individual mandate”).353 Minimum essential coverage
includes government-sponsored programs (including Medicare, Medicaid, and CHIP, among
others), eligible employer-sponsored plans, plans in the individual market, grandfathered group
health plans and grandfathered health insurance coverage, and other coverage as recognized by
the Secretary of Health and Human Services (“HHS”) in coordination with the Secretary of the
Treasury.354 The tax is imposed for any month that an individual does not have minimum
essential coverage unless the individual qualifies for an exemption for the month as described
below.

The tax for any calendar month is one-twelfth of the tax calculated as an annual amount.

The annual amount is equal to the greater of a flat dollar amount or an excess income amount.

The flat dollar amount is the lesser of (1) the sum of the individual annual dollar amounts for the
members of the taxpayer’s family and (2) 300 percent of the adult individual dollar amount. The
individual adult annual dollar amount is $695 for 2017 and 2018.355 For an individual who has
not attained age 18, the individual annual dollar amount is one half of the adult amount. The
excess income amount is 2.5 percent of the excess of the taxpayer’s household income for the
taxable year over the threshold amount of income for requiring the taxpayer to file an income tax
return. The total annual household payment may not exceed the national average annual
premium for bronze level health plans for the applicable family size offered through Exchanges
that year.

Exemptions from the requirement to maintain minimum essential coverage are provided for the
following: (1) an individual for whom coverage is unaffordable because the required
contribution exceeds 8.16357 percent of household income, (2) an individual with household
income below the income tax return filing threshold, (3) a member of an Indian tribe, (4) a
member of certain recognized religious sects or a health sharing ministry, (5) an individual with
a coverage gap for a continuous period of less than three months, and (6) an individual who is
determined by the Secretary of HHS to have suffered a hardship with respect to the capability to
obtain coverage. 

House Bill
No provision.

Senate Amendment

The Senate amendment reduces the amount of the individual responsibility payment,
enacted as part of the Affordable Care Act, to zero.
Effective date.−The provision is effective with respect to health coverage status for
months beginning after December 31, 2018.
Conference Agreement
The conference agreement follows the Senate amendment.

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