By Bernard J. Wolfson|California Healthline
Californians, be cautioned: A new state law could make you liable for a significant tax penalty if you do not have health insurance next year and beyond.
However some of you need not stress: The law contains several exemptions that will allow certain people to avoid the penalty, among them prisoners, low-income homeowners and those living abroad.
“It will be actually crucial that people get clear guidance and guideline to make certain they don’t unintentionally pay a charge when they are qualified for an exemption,” states Laurel Lucia, director of the Health Care Program at the University of California-Berkeley’s Center for Labor Research and Education.
California’s penalty is modeled on the one originally in the federal Affordable Care Act. Congress removed the federal penalty, effective this year.
The Golden State will sign up with Massachusetts, New Jersey, Rhode Island, Vermont and Washington, D.C., in requiring their homeowners to have health protection and dinging those without it.
A lot of types of insurance coverage, consisting of Medi-Cal, Medicare and employer-sponsored protection, will satisfy California’s protection requirement. People who buy insurance coverage on their own and their families, either through Covered California, the state’s health insurance exchange, or the open market, will have until Jan. 31 to purchase a health plan for 2020.
If you aren’t covered and owe a charge for 2020, it will be due when you file your income tax return in 2021. The penalty will amount to $695 for an adult and half that much for dependent children. Some people with greater earnings rather will have to pay 2.5% of their income, which could make their penalty quite a bit heftier.
Penalty payments are anticipated to raise $317 million in the first year they are gathered, according to the state Legislative Expert’s Workplace. The money will help spend for new state aids meant to make insurance coverage more affordable for some people.
You will not have to pay the penalty if you are uninsured for 3 consecutive months or less during the year, or if you are incarcerated or are Native American. If you are in the U.S. illegally.
General challenge exemptions likewise are offered if you are dealing with individual or family difficulties, consisting of homelessness, domestic violence, bankruptcy, expulsion or the effects of a natural catastrophe.
If your household income is listed below the threshold for submitting a tax return, and you’re off the hook. This was the most common exemption from the federal penalty, according to Irs data based on 2016 returns. It might be even more popular under the California law, considering that the state’s filing threshold is greater than the federal one, Lucia states.
You can likewise declare an exemption if you would have to spend more than 8.24% of your income on insurance coverage premiums in 2020. This so-called price exemption was likewise among the most common under the federal law.
How you declare an exemption depends upon the type you are looking for.
Covered California will manage 3 types of exemptions: religious conscience, basic challenge and price. Each will require submitting a different application, and the applications will be offered beginning in January, states James Scullary, an exchange representative.
For other exemptions, you’ll need to use when you file your 2020 return with the Franchise Tax Board in early 2021. A tax board spokeswoman promises that “our tax return and instructions will include information for all exemptions claimed on the income tax return.”
You can likewise use to the tax board for a price exemption when you file your return.
Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research, states the income level to qualify for the price exemption is too expensive and presses many middle-class families to pay a charge even when they are hard-pressed to purchase insurance coverage.
Steven Morelock, a resident of Los Angeles, paid numerous dollars in federal charges for several years because he felt too economically stressed out to pay $250 a month for a high-deductible health plan. He was currently spending nearly half of his $2,500-a-month salary in lease alone.
“I would have had to alter my habits very drastically,” states Morelock, 41, a labor organizer. “It would have cut the amount of money I had for non-fixed expenses by about half.” He finally got employer-sponsored insurance coverage late last year.
Another exemption that has actually stirred some argument is for subscription in a health care sharing ministry– an association of consistently similar people, mainly Christians, who cover one another’s medical expenses.
Others and legislators who opposed including this exemption in California’s law argued that the ministries are subject to little regulatory scrutiny, the protection they provide is limited, and it’s not guaranteed. More recently, issues have emerged about sham ministries taken part in deceptive business practices.
Dr. Dave Weldon, president of the Alliance of Health Care Sharing Ministries, acknowledges some of the constraints and states the companies he represents “all counsel their members that this is not insurance coverage, there’s no agreement, there’s no obligation to pay.”
Bob Stedman, 55, states he and his family were exempt from the federal penalty every year because of their subscription in Samaritan Ministries International. The Lake Forest, Calif., resident plans to take the exact same exemption under the California law.
Stedman figures he’s conserving about $1,000 to $1,500 a month in premiums compared with routine insurance coverage, and was pleased when the $50,000 costs he got following a stroke was heavily discounted by the medical facility and then almost entirely covered by other ministry members. And knowing his money is not being utilized to finance abortions, which most commercial health plans in California are required to cover, provides him “the benefit of a clear conscience,” he states.
Weldon states the exemption is called for on those grounds alone. “This country has a long history of religious lodging,” he states.
If you’re not sure whether you might qualify for an exemption, you can get more information from Covered California or the tax board.
However don’t restrict yourself to those 2 firms. Insurance representatives and tax preparers throughout the state are trying to master the details of the new law, and they can help.
For a list of insurance coverage representatives whose help is totally free, go to to the Covered California site and click “find help” or go to the site of the National Association of Health Underwriters (www.nahu.org) and strike “find an agent.” The California Society of Tax Professional (https://www.cstcsociety.org/) and the California Society of Certified Public Accountants (www.calcpa.org) can help you find a tax preparer.
This story was produced by Kaiser Health News, which releases California Healthline, a service of the California Health Care Foundation