PPACA Tax Overview BenefitMall Reference Guide - (Page 15)

PART D: Putting the Coverage Puzzle Together 5.12 How do all of the coverage options authorized by PPACA fit together? PPACA uses an array of tax incentives, tax penalties, other funding mechanisms and regulatory requirements to promote universal coverage. Whether that goal will be met or not is beyond the scope of this Reference Guide. However, it is important to understand the landscape of all of the coverage options so that brokers, employers and others understand how the federal government envisions that this will take place. Law Professor Zelinsky provides a succinct overview when he writes: Under PPACA, all individuals subject to the statute’s insurance requirement must, starting in 2014, have in force “minimum essential coverage.” Such coverage can take one of five forms: • First, health services from approved government programs such as Medicaid, Medicare, CHIP , and federal veterans medical care qualify as minimum essential coverage, satisfying the individual insurance mandate. • Second, participation in an “eligible employersponsored” plan constitutes such coverage. • Third, health coverage acquired in a state’s “individual market” qualifies as “minimum essential coverage” and thus discharges the individual insurance mandate. • Fourth, the individual mandate is satisfied through health coverage “under a grandfathered health plan,” which generally means any “group health plan or health insurance coverage” in effect on the day PPACA was enacted March 23, 2010. 5.13 • Finally, the Secretary of Health and Human Services, after consulting with the Secretary of the Treasury, may recognize any other program as constituting minimum essential coverage for purposes of the individual mandate.27 What are the core themes that emerge when reviewing PPACA’s health-related tax provisions? Law Professor Zelinsky identifies four themes that emerge from studying the “the generally applicable, health-related tax provisions of PPACA:” • First, he notes that many of the provisions have not been finalized. He writes, “It is unclear whether these tax measures will take effect as scheduled or will take effect in their current forms.” • Secondly, he points to the “enormous complexity” of PPACA’s tax provisions. “Such complexity will impose daunting enforcement challenges upon the IRS and will create equally formidable compliance burdens for firms and individuals, most notably, for small businesses and taxpayers of modest means.” • Thirdly, he concludes that the pathway to implementing PPACA’s coverage goals will be “incremental” because PPACA builds upon and reinforces the “existing systems of privatelyprovided health insurance and of employersponsored medical care.” • Finally, he observes that the fourth theme to emerge “from a survey of the tax provisions of PPACA” is the lack of any “significant efforts to control health care costs.” He fears that PPACA will “accelerate U.S. health care spending.” THE COVERAGE TOGETHER 15

Table of Contents for the Digital Edition of PPACA Tax Overview BenefitMall Reference Guide

PPACA Tax Overview BenefitMall Reference Guide
Table of Contents
Individual Mandate & Tax Implications
Premium Subsidies
Employer Requirements & Tax Implications
PART A: Small Employer Tax Credits
PART B: Large Employer Tax Penalties
PART C: Employer W-2 Reporting Requirements
PART D: Employer Deductions for Retiree Drug Coverage
Additional PPACA Tax Provisions Impacting Employers & Employees
PART A: The Unearned Income Medicare Contribution Tax
PART B: Excise Tax on Comprehensive, High-Cost Health Insurance Plans
PART C: Assessing the Impact of PPACA on HSAs, MSAs, FSAs, & HRAs
Medicaid & Medicare Changes & the Impact on Employers
PART A: The Expanding Medicaid Program
PART B: Emphasis on Prevention & Related Services
PART C: Medicare Part D Updates
PART D: Putting the Coverage Puzzle Together

PPACA Tax Overview BenefitMall Reference Guide

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