There are several reasons you may have to file taxes under ObamaCare (the Affordable Care Act). Learn how to file your ObamaCare taxes in 2016 and beyond including: how to make a Shared Responsibility Payment for not having coverage, how to report health coverage known as Minimum Essential Coverage, how to adjust and report Premium Tax Credits, and how to report exemptions.
TIP: Make sure you are filing 2015 forms 2015 coverage when filing taxes (taxes you file for April 15, 2016). If you are filing without tax assistance, take the time to verify the instructions and make sure you are using the correct tables for 2015 coverage (this can change based on which form you are filing).
Who Has to File Taxes for ObamaCare?
Everyone, who has to file taxes, must at least report if they had coverage on their 1040.
- If you, or a dependent, missed at least one full month of coverage last year, you’ll need to file the Exemptions form.
- If you, or a dependent, got Advanced Tax Credits you’ll need to file a Premium Tax Credit form and will receive a helpful 1095-A form in the mail in regards to your coverage.
- If you, or a dependent, got a Marketplace plan, but chose to receive your Tax Credits as a part of your year end tax refund, you’ll need to file a Premium Tax Credit form.
- If you, or a dependent, has Medicaid, Medicare, or another insurance type you’ll only need to fill out line 61 of your 1040 for ObamaCare.
Click to See Full Table of Taxes for Individuals and Families
|And everyone in your tax household had health coverage for the entire year||Will simply check the box on line 61 of Form 1040, line 38 of Form 1040-A, or line 11 of Form 1040-EZ|
|Enrolled in health insurance through the Marketplace||Should receive a Form 1095-A Health Insurance Marketplace Statement from the Marketplace|
|Received a Form 1095-A, Health Insurance Marketplace Statement, showing you received the benefit of advance payments of the premium tax credit in 2014||Must file a tax return in 2015 and reconcile the advance payments with the amount of the premium tax credit allowed on your return|
|Need to reconcile the advance payments of the credit with the credit allowed||Make the calculations using IRS Form 8962 Premium Tax Credit (PTC)|
|Must repay any excess advance payments of the premium tax credit||Must report the information on line 46 Form 1040 or line 29 of Form1040-A, and cannot file Form 1040-EZ|
|Are claiming the premium tax credit and did not benefit from advance payments of the premium tax credit||Must file a tax return and IRS Form 8962, Premium Tax Credit (PTC)|
|Did not receive a Form 1095-A, Healthcare Insurance Marketplace Statement, from the Marketplace||Should contact the state or federal Marketplace through which you enrolled|
|Are claiming an exemption from the requirement to have health coverage for anyone on your tax return||Will complete Form 8965, Health Coverage Exemptions, and submit it with your tax return|
|Still need to obtain a religious conscience exemption or a hardship exemption that can only be granted by the Marketplace||Should file an application with the Marketplace and follow the instructions below about how to report exemptions from the Marketplace on your tax return|
|Obtained an exemption from the Marketplace, and received your unique Exemption Certificate Number||Will enter the Exemption Certificate Number in Part I of Form 8965, Health Coverage Exemptions, and submit the form with your return|
|Applied for an exemption from the Marketplace, but do not currently have an Exemption Certificate Number||Will enter ‘PENDING’ in Part I of Form 8965 Health Coverage Exemptions, and submit the form with your return|
|Are claiming an exemption that can be granted only from the IRS||Will not need an Exemption Certificate Number, but will complete Parts II and III of Form 8965, Health Coverage Exemptions, and submit the form with your return|
|Are able to obtain the exemption from either the IRS or the Marketplace||Should obtain the exemption from the IRS by completing Part II and III of Form 8965, Health Coverage Exemptions, and attach this form to your federal tax return when you file|
|Are making a shared responsibility payment because you did not have health coverage or qualify for an exemption for any month in 2014||Will enter the payment amount on line 61 of Form 1040, line 38 of Form 1040-A, or line 11 of Form 1040-EZ|
Who Doesn’t Have to File Taxes for ObamaCare?
If you don’t have to file a tax return because your income is too low, then you are automatically exempt and don’t need to file. Learn about the filing limit.
Even if you don’t have to file, you may want to file for many reasons. For example, if you had Marketplace coverage and then lost your source of income, you may be owed tax credits for the months you had coverage. You can also report exemptions due to income for months you did not have coverage on the Health Coverage Exemptions form found below.
All ObamaCare Related IRS Forms, Instructions, and Our Simplified Instructions
We have covered most of the tax filing requirements below in an easy to understand way. You can find all the official forms and instructions from the IRS, as well as, our simplified guides to each type of form related to ObamaCare below. For more details go to IRS.gov.
ObamaCare Facts Guides:
Official IRS forms and Instructions for 2014 (we will update these with 2015 forms starting in February 2016):
A Quick Look at the 1094 and 1095 Forms
Individuals don’t have to fill out 1094 or 1095 forms. They are sent by whomever provided you coverage. They include months you had coverage and premium amounts, and are used to fill out 1040, 8962, and 8965 forms. If you got marketplace coverage in 2014, you’ll get a copy of a 1095-A form sent to you. The filing date for the Marketplace is January 31st, 2015, so most people got their 1095-A in mail by February 2nd, 2015. However, some states have reported delays due to last minute changes to the form. If you have not yet received your 1095-A, call or visit your Marketplace to find out more information. If you haven’t filed yet we suggest double checking the information on your form.
Other 1095 forms (1095-B and 1095-C) don’t have to be sent until 2016 due to transition relief for non-marketplace employers and insurers. So if you didn’t get tax credits and don’t get a 1095, simply report your health coverage accurately on your 1040.
A Quick Look At Form 1040
Open up 1040 form for 2014 and the 1040 instructions. Go to line 61 (use the command find function on your keyboard). This is where you report your coverage, or pay the Shared Responsibility Payment if you owe it. Many people will only have to fill out this one line reporting that they had coverage for the entire year. If you are only filing out this line you can us a 1040-EZ form. (It’s line 38 on a Form 1040-A or line 11 Form 1040-EZ)
AGI (adjusted gross income) is on line 37. And while it doesn’t say so, Modified AGI or MAGI is typically the total on line 41.
If you got Premium Tax Credits, you’ll Adjust Tax Credits using Form 8962 on line 46 and report your Net Premium Tax Credit amount from Form 8962 on line 69.
You’ll use line 25 for Health Savings Account deductions and line 29 for reporting for Self-employed Health Insurance deductions.
See our ObamaCare Facts simplified guide to 1040 forms for more information. Including information on Schedule A deductions.
A Quick Look at Form 8962
Open up Form 8962, Premium Tax Credit (PTC). This is the form you will need to report your household Modified AGI (MAGI), your Federal Poverty Level amount, your families health insurance premium, exemptions, and the cost assistance you received. See below for more details on this form, see our page on Form 8962 for simplified instructions.
Quick Look at Form 8965 Health Coverage Exemptions
Form 8965 Health Coverage Exemptions allows you to claim hardships. Make sure to include the Electronic Confirmation Number (ECN) from the Marketplace, if needed, for that exemption. You’ll attach this form with your 1040 and use it to determine what you owe for the Shared Responsibility Payment. See full list of exemptions and their numbers and requirements or see our simplified step-by-step guide to form 8965, Health Coverage Exemptions.
Quick Look at Instructions for Figuring your Shared Responsibility Payment
Page 5 of form 8965 instructions also provides a worksheet for calculating the Shared Responsibility Payment, as well as more details on how the payment works. See our guide to the Shared Responsibility Fee (including a simplified instructions for calculating the fee).
How to Get Help Filing Taxes
Going to a local tax professional is probably your best bet for filing taxes. Establish a relationship and make sure to take advantage of discounts (they are always offered at tax time, especially this year due to the ACA). The more complicated your taxes, the more important it is to get help. There are so many odd deductions, especially for folks at lower income levels, that not getting help often ends up costing you in lost savings.
- You can also use the IRS Tax Help Line for help: (800) 829-1040
- If you make less than $60,000 a year, you can use the IRS’ Free File option.
- If you make less than $53,000 a year, you can use the IRS’ free Volunteer Income Tax Assistance program.
- The IRS’ Tax Counseling for the Elderly program is free for those 60 and over.
- Enroll America will offer no-cost local help using Intuit TurboTax.
- You can use any major tax assistance software.
Or if you can ask ObamaCare Facts (us) any questions you have.
Quick Facts for Filing Taxes For ObamaCare
Here are some quick facts on filing taxes under the Affordable Care Act:
- Taxes for 2014 must be filed by the IRS tax filing deadline: Wednesday, April 15th 2015.
- If you used the Marketplace, or missed a full month of coverage in 2014, you’ll need to file forms related to ObamaCare beyond reporting coverage status on your 1040.
- Important forms are 1040 (your main tax form), Form 8962, Premium Tax Credit (PTC), Form 8965 Health Coverage Exemptions, and Form 1095-A reporting your Marketplace coverage.
- When filing taxes in 2015, you’ll be paying the fee at the 2014 rate and you’ll base cost assistance on the 2013 Federal Poverty Guidelines.
- Cost assistance, the fee, and exemptions are based on Modified Adjusted Gross Income (MAGI). Modified Adjusted Gross Income is Adjusted Gross Income (AGI) as found on your 1040, plus any foreign earned income and tax-exempt interest you receive during the taxable year.
- MAGI is often referred to as household income. For the ACA, household income is your families Modified Adjusted Gross Income and includes the incomes of all of your dependents who are required to file tax returns. For example, if your dependent is 18-26 years old and covered under your families insurance, then their income is included in your MAGI.
- If you have to file taxes, you’ll have to report the status of your health coverage for the entire year and any cost assistance you may have received in 2014. If you aren’t required to file, you may choose to anyways to take advantage of refunds and assistance programs.
- If you didn’t take the full Premium Tax Credit in advance, or you made less than you projected in 2014 and didn’t adjust your info in the marketplace, you can deduct the remaining amount on your Federal Income Taxes using Form 8962, Premium Tax Credit (PTC).
- If you went without minimum essential coverage for more than 4 months in 2014 (3 in 2015 and beyond) you’ll have to make a Shared Responsibly Payment for each month you, or a household member you claim as a dependent, went without coverage or an exemption. The fee is 1/12th of the annual fee up to the family max or a percentage of your household income which is capped at the national average of a Bronze plan. See Individual mandate for detailed information on the fee and requirement.
- You’ll get a 1095-A, 1094-B, 1095-B, or 1095-C form from your insurer about your coverage. If you had more than one source of coverage, you’ll get multiple forms. You will use these these forms to report minimum essential coverage. You’ll also use that form to help fill out Form 8962, Premium Tax Credit (PTC).
- For 2015 only: Not all providers are required to provide you 1094-B, 1095-B (multiple and other insurer coverage), or 1094-C, 1095-C (employer coverage) forms according to the IRS. 1095-A (marketplace coverage) forms will be sent after January 31st, 2014 if you had a Marketplace plan in 2014.
- Notice 2013-45 provides transition relief for 2014 from the section 6055 reporting requirements for health coverage providers. Accordingly, the reporting requirements do not apply for 2014. However, coverage providers are encouraged to provide information returns for coverage provided in 2014, which are due to be filed and furnished in early 2015. Returns filed voluntarily will have no impact on the tax liability of the health coverage provider or the individuals affected. For more information about voluntary filing in 2015, see IRS.gov.
- If you didn’t get your 1095, or got the wrong one, and need to calculate the second lowest cost sliver plan, you can use this tool. (You can use the lowest cost bronze plan tool on that page for affordability exemptions.)
- If you had an exemption for any months you may need a Electronic Confirmation Number (ECN) provided by the Health Insurance Marketplace HealthCare.Gov.
- Some exemptions require proof and others don’t. The one’s that require proof, take time! Apply for exemptions early or you’ll risk having to delay filing your taxes.
- Some exemptions apply to a short window of time, usually 3 months, while others apply to the full calendar year.
- You can’t go to jail for not paying the fee. The IRS cannot enforce the Individual Shared Responsibility Provision with jail time, liens, or any other typical method of collection. They can, however, withhold your Federal Income Tax refund.
- If your income is below the minimum threshold for filing a tax return ($10,150 for an individual or $20,300 for a couple) or the lowest cost coverage offered to you would cost more than 8% of MAGI for self-only coverage, you are exempt from the fee for not having coverage. You may still qualify for marketplace cost assistance or Medicaid.
- Try using an Health Savings Account HSA to bring down your MAGI for maximum savings on qualifying high deductible plans. If you do, you’ll need to file form 8889.
- The first time folks will pay the “ObamaCare tax” for not having insurance is 2015, after open enrollment closes. Those who went without coverage since 2014 will end up owing the fee for 2014 and 2015 because minimum essential coverage can only be obtained during open enrollment (which ends Feb 15) unless you qualify for a special enrollment. On that note, the largest decrease in uninsured is expected to be during 2016 open enrollment, which starts November 15th, 2015 for coverage that begins on January 1st, 2016.
- Small businesses can use the SHOP to obtain coverage and tax credits for employees. Some larger businesses can use the SHOP for coverage too.
- Larger businesses and higher earning employees may also have to pay the increased Medicare Part A tax. Then there is also the 3.8% net investment income tax many high earners will face. Generally, large employers and higher earning individuals will be responsible for additional taxes and, thus, will need to report them. See our ObamaCare taxes page for a full list of taxes on high earners with a taxable income of $200,000 individual / $250,000 family.
Reporting Health Coverage to the IRS
Everyone who has to file taxes for 2014 will have to, at the very least, report about the status of their health coverage throughout the year on their Federal Income Taxes due April 15, 2015. This will be reported on Form 1040, line 61 (or Form 1040A, line 38; or Form 1040EZ, line 11). Only Minimum Essential Coverage counts as health coverage under the ACA.
If you had marketplace coverage, you’ll get a 1095-A form after January 31st, 2015. This will show you the months you had coverage. If you didn’t have coverage for every month, you’ll need to complete the Shared Responsibility Payment worksheet and/or exemptions worksheets.
How to Report Other ObamaCare Forms
Whether you had health coverage all year, went without health insurance for at least one full month, need to adjust income for Premium Tax Credits, or need to confirm an exemption, you’ll need to attach the correct form/s to your 1040. Employers will also need to file tax forms if they qualified for tax credits through the marketplace, or were required to insure their employees.
See sections below for breakdowns of each form you may need to attach to your 1040.
The IRS suggests that filing your taxes electronically is the easiest way to file a complete and accurate tax return. Electronic Filing options include free Volunteer Assistance, IRS Free File, commercial software and professional assistance.
How to Report Minimum Essential Coverage For 2014
When you file your 2014 taxes by April 15, 2015, you’ll report whether or not you had coverage each month on line 61 of a standard 1040. For 2014 ONLY this is based on “the honor system” if you got non-marketplace coverage (due to transition relief discussed earlier on this page). So if you had coverage you answer “yes”, if you didn’t you answer “no” and calculate your fee.
Keep in mind if you got Marketplace coverage the Marketplace backs this up. If you got coverage outside the Marketplace or through an employer this is all verifiable in the case of an audit. You have the option of skipping this question as well, by marking neither “yes” or “no”. Keep in mind you must sign your tax return under “penalties of perjury”, so, the best answer is the honest one. We recommend obtaining and maintaining minimum essential coverage throughout each year.
How to Report Minimum Essential Coverage For 2015
When you file your taxes for 2015 and beyond, you will report minimum essential coverage on your 1040 where it says “full year coverage”. If the answer is “yes”, then you put zero as the amount. If the answer is “no,” then you need additional forms. While this is still based on “the honor system,” all insurers and employers are required to furnish 1095 forms by 2016 which show your coverage months, so it’s much more verifiable.
You’ll report coverage as shown on your 1095-A, 1095-B, or 1095-C form sent by your insurance provider. It will show what months you had coverage and how much assistance you got. If you had multiple insurance sources, you may get more than one form. This will help you to figure out if you owe money for any months that you went without coverage.
Deferred 1095 Forms For 2014 Only
Please note that some requirements have been deferred from 2014 to 2015, meaning they won’t apply until taxes are filed for April 15, 2016. This includes the requirement for employers and providers to send 1095-B or 1095-C forms showing minimum essential coverage. However, if you received Advanced Premium Tax Credits you will get a 1095-A form. Make sure you get yours because you can’t complete the Premium Tax Credit form without it. As an individual or family, you’ll still need to report the status of your health coverage, but especially if you got Marketplace cost assistance. See IRS transition relief for 2014.
How to File Taxes for Not Having Coverage
If you didn’t obtain and maintain minimum essential coverage for each month in 2014, you’ll need to make a Shared Responsibility Payment for each month you or a household member went without coverage, unless you obtained an exemption (everyone gets a short coverage gap of 4 months in 2014, and 3 months in years there after).
If you had Minimum Essential Coverage throughout the year, you check the box on line 61 of your 1040 (or Form 1040A, line 38; or Form 1040EZ, line 11).
If you didn’t, then you’ll need to follow the instructions on page 50 of the 1040 instructions for an overview and see page 5 of the exemptions instructions for a more detailed breakdown. This involves calculating which fees you must pay and calculating tax credits on form 8962 if applicable. We suggest using our simplified instructions for calculating the fee if you will do it by hand or just want to learn more about how the fee works.
For 2014, the annual fee is $95 per adult and $47.50 per child (up to $285 for a family) or 1% of your household income that is above the tax return filing threshold for your filing status, whichever is greater.
- You’ll need to make a Shared Responsibility Payment for 1/12 of the above amount, per household member, for each month they went without coverage for the flat dollar amount. The Flat Dollar Amount Worksheet is included in the exemptions instructions.
- For the percentage payment, you’ll pay 1/12 of the percentage per month, per household member, not multiple instances of the percentage.
- The part where you divide the fee by 12 comes in further down the calculations worksheet, so don’t be scared by seeing large numbers earlier on if you fill the worksheet out by hand.
- You can’t owe more than $285 if you pay the flat amount.
- If you pay the percentage: The total penalty for the taxable year cannot exceed the national average of the annual premiums for a bronze level health insurance plan offered through the Health Insurance Marketplaces. For 2014, the annual national average premium for a bronze level health plan available through the Marketplace is $2,448 per individual ($204 per month per individual), but $12,240 for a family with five or more members ($1,020 per month for a family with five or more members). See Rev. Proc. 2014-46.
- The fee increases each year.
Check out these basic examples of the payment calculation and the federal tax filing requirement thresholds. For more detailed examples, see the Individual Shared Responsibility Provision final regulations.
How to Make Shared Responsibility Payment
You will do the calculations from the 8965 worksheet to you figure out what you owe for each month and report that on line 61 of your 1040 (or Form 1040A, line 38; or Form 1040EZ, line 11).
To fill out the Shared Responsibility Payment Worksheet, you’ll need to look at your 1095-A, 1095-B, or 1095-C form sent by your insurance provider for any months you had coverage and Form 8965 Health Coverage Exemptions. You’ll then calculate the months you, or a household member, didn’t have coverage, or an exemption, and pay a fee based on your Modified Adjusted Gross Income that is above the filing threshold. The total amount from the worksheet is reported on your 1040.
How to File Taxes for ObamaCare Exemption
To report most exemptions on your taxes you must first apply for an exemption through the Marketplace. After you have been granted an exemption, the Marketplace will mail you a notice of the exemption eligibility result. If you’re granted an exemption, the Marketplace notice will include your unique Exemption Certificate Number (ECN).
You’ll simply report the ECN on your Form 8965 Health Coverage Exemptions along with any other exemptions which don’t require an ECN.
Minimum Filing Threshold for 2014 Tax Returns
When preparing your 2014 tax returns, you won’t have to file if you make under these amounts. You also won’t owe the fee on these amounts. You’ll use Gross Income and filing status to determine your filing threshold amount. See Tax Filing Thresholds for more details.
2014 Federal Tax Filing Requirement Thresholds
|Filing Status||Age||Must File a Return If Gross Income Exceeds|
|65 or older||$11,700|
|Head of Household||Under 65||$13,050|
|65 or older||$14,600|
|Married Filing Jointly||Under 65 (both spouses)||$20,300|
|65 or older (one spouse)||$21,500|
|65 or older (both spouses)||$22,700|
|Married Filing Separately||Any age||$3,950|
|Qualifying Widow(er) with Dependent Children||Under 65||$16,350|
|65 or older||$17,550|
How to File Taxes for the Premium Tax Credit
If you received Advanced Premium Tax Credits, either in part or in whole, or if you plan to claim the Premium Tax Credit, you must file a federal income tax return. Specifically, you’ll need to file Form 8962, Premium Tax Credit (PTC).
We provide a detailed tutorial for filling out the Premium Tax Credit form. The form of course includes directions which are fairly easy to follow if you know what everything means, but potentially a little confusing and time consuming.
IMPORTANT: There are limits to the amount of Advanced Premium Tax Credit (APTC) that must be paid back. These limits are based on income.
|Income % of FPL||Filing Status:
|Less than 200% FPL||$300||$600|
|At least 200% FPL
but less than 300%
|At least 300% FPL
but less than 400%
|If your year end income exceeds 400% FPL, you will have to return the total amount of Advanced Premium Tax Credits you received.|
If you choose to get it now (Advanced Premium Tax Credits): When you file your tax return, you will subtract the total advance payments you received during the year from the actual Premium Tax Credit calculated on your tax return. If the Premium Tax Credit computed on the return is more than the advance payments made on your behalf during the year, the difference will increase your refund or lower the amount of tax you owe. If the advance credit payments are more than your actual Premium Tax Credit, the difference will increase the amount you owe and result in either a smaller refund or a balance due. This is an attractive, but risky move. Owing money at the end of the year for something you already had stings a bit. Of course tax credits are based on income, so if it was calculated correctly upfront, you’ll only owe significant amounts of money if you increase your household income significantly.
If you choose to get it later (Premium Tax Credit): You will claim the full amount of your actual Premium Tax Credit when you file your tax return. This will either increase your refund or lower your balance due. This is the safer move. As attractive as an up-front credit is, saving money on taxes is a lot more exciting then owing back money.
Learn more from the IRS.
Either way, it’ll be important to adjust tax credits each year, both on your taxes and through the marketplace, to ensure you get the assistance you deserve, not more or less. Keep in mind H&R Block is an accounting service that will most likely see a giant boom in businesses under the ACA.
Adjusting for Other ObamaCare Subsidies
If you got Cost Sharing Reduction (CSR) subsidies or Medicaid, but your income increased, and as a result, disqualified you from part of the assistance or the full amount, you will have to report this on your taxes. Unlike Premium Tax Credits, Medicaid and Cost Sharing Reduction subsidies do not have to be paid back. This may be an advantage for those whose yearly incomes vary slightly, but are consistently on the edge of the Cost Sharing Reduction subsidy income thresholds, especially if the full Premium Tax Credit offered is NOT taken in advance. See our Federal Poverty Level page to see where your income falls.
For most people, however, it is still important to report changes to income and family status to the Marketplace, so that changes to your Advanced Premium Tax Credits can be made when they happen.
Reporting ObamaCare for Small Businesses
Most businesses will simply defer tax filing duties to their accountant. Small businesses who received a tax credit for health insurance and will be filing themselves should go to IRS.gov for detailed filing information.
Tax credits for small businesses are available retroactively since 2010, although some restrictions apply. So, if you didn’t claim your tax credits in past years, you can still claim them.
In order to claim the tax credit for Small Business health insurance premiums, you’ll need to use a Form 8941 to calculate the credit. For detailed information on filling out this form, see the Instructions for Form 8941. If you are a tax-exempt organization, include the amount on line 44f of the Form 990-T. You must file the Form 990-T in order to claim the credit, even if you don’t ordinarily do so.
If your business is eligible for the SHOP you can claim your tax credit there, but you’ll still need to fill out Form 8941.
If you are a small business, include the tax credit amount as part of the general business credit on your income tax return.
Reporting ObamaCare Taxes for High Earners
Anyone in a higher tax bracket should know that there are other taxes which apply to them. Like with businesses, most folks in higher tax brackets will have the help of an accountant. Please see our section on ObamaCare taxes to learn about taxes that may affect you, like the new Medicare tax on investment income.
Don’t forget, large businesses who are required to provide coverage, must report coverage status of employees and must make a Employer Responsibility Payment. The amount of the payment depends upon whether the employee used Marketplace cost assistance or not. See employer mandate for more details.
Other ObamaCare Tax Return Forms
See our complete list of Obamacare related forms closer to the top of this page. Here you can find other less common forms related to healthcare and the ACA.
Other Tax Form Examples Regarding the ACA in 2014 will be added below:
We will provide screen shots, additional forms, and further advice as we learn more related to the ACA and taxes. When in doubt we suggest referring to HealthCare.Gov, the IRS.Gov, or a local accountant.
Learn more about filing taxes for 2014 from Forbes.