The Affordable Care Act: Tax Season Special Enrollment Period

Elizabeth Escovar
Elizabeth Escovar

March 23, 2015 marked the 5th anniversary of The Affordable Care Act (ACA). President Obama signed this piece of legislation in 2010 with the goal to reduce the number of uninsured Americans aiming for access to quality healthcare at an affordable price. At the end of the February 15, 2015 Open Enrollment deadline, the Centers for Medicare and Medicaid Services (CMS) reported about 11.7 million consumers with a selected health plan through Federal or State-Based Marketplaces.

There are many components to the ACA and while there have been efforts to educate and inform individuals and families of insurance benefits, exemptions, special enrollment periods, and the penalties for not being enrolled in a health plan, there is still much work to do in this area.

Many are currently facing the Individual Shared Responsibility Payment as they file their 2014 Income Tax Returns. The Shared Responsibility Payment is commonly known as the “penalty” individuals and families have to pay as a consequence for not having appropriate health coverage through 2014. The established rate for the year 2014 was set to $95 per adult and $47.50 per child (with a maximum limit of $280) or 1% of taxable income—whichever amount is higher. In 2015, the rate increased to $325 per adult and $162.50 per child (with a maximum limit of $975) or 2% of taxable income—again, whichever amount is higher.

To reach those having to pay the 2014 penalty, CMS announced a Tax Season Special Enrollment Period from March 15-April 30, 2015. People living in states that use the Federal Marketplace have an opportunity to avoid the 2015 penalty by enrolling in a health plan within this time frame even after the original February 15, 2015 open enrollment deadline.

To meet eligibility requirements, one must:

  • Live within a state using a Federal Marketplace
  • Not have health insurance coverage for the year 2015
  • Owe the 2014 “penalty”
  • Claim one did not know the healthcare law required health coverage for the year of 2014
  • Claim one did not understand how that requirement would affect their household

Get Covered America has created a tool for consumers that may need local in person assistance through the enrollment process. Many local community organizations are offering FREE office hours and appointments with certified In Person Assistors (IPAs) and Certified Application Counselors (CACs) to answer questions or help consumers with complex cases. Consumers are also encouraged to contact the marketplace directly through www.healthcare.gov or calling 1-800-318-2596.

Elizabeth Escovar is an Outreach Specialist with ENROLL VA! and Northern Virginia Family Service (NVFS). NVFS offers FREE appointments for Virginia residents interested in enrolling in health coverage through the Federal Marketplace. Virginia residents can schedule an appointment using the Get Covered America tool or by calling 571-748-2580. Services are available in English and Spanish.