Will I get penalized if I underestimate my income for Obamacare?
If you receive Affordable Care Act tax credits and underestimate your annual income, you may have to pay them back. The rules vary depending on the year.
If you find that you've overestimated your income when enrolling in a Covered California plan, it can have significant implications for your healthcare subsidies. Overestimation typically means you received less in subsidies than you were actually eligible for.
If you underestimated your income for that year and received a subsidy, you will need to pay the entire subsidy back the next time you file your taxes. You must report income changes to Covered California within 30 days. Note that you'll need to report income changes to Medi-Cal within 10 days.
If your income estimate goes up or you lose a household member — You may qualify for less savings than you're getting now. If you don't report the change, you could have to pay money back when you file your federal tax return. The amount you pay for your health insurance every month.
If you don't qualify for either Medicaid or Marketplace savings. You can get care at a nearby community health center. The health care law has expanded funding to community health centers, which provide primary care for millions of Americans. These centers provide services on a sliding scale based on your income.
How can I avoid it? The easiest way to avoid having to repay a credit is to update the marketplace when you have any life changes. Life changes influence your estimated household income, your family size, and your credit amount. So, the sooner you can update the marketplace, the better.
The credit is “refundable” because, if the amount of the credit is more than the amount of your tax liability, you will receive the difference as a refund. If you owe no tax, you can get the full amount of the credit as a refund.
Who is eligible for health insurance subsidies? In 2024, you'll typically be eligible for ACA subsidies if you earn between $14,580 and $58,320 as an individual.
The income range is $30,000 to $120,000 in 2024 for a family of four. (Income limits may be higher in Alaska and Hawaii because the federal poverty level is higher in those states.) The American Rescue Plan Act of 2021 also extended subsidy eligibility to some people earning more than 400% of the federal poverty level.
One of the most common proofs is a pay stub. If you submit a pay stub, make sure that it is current and within the last 45 days; otherwise, Covered California may not accept it.
Do you have to pay back tax credit for health insurance?
If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return.
The Marketplace uses an income number called modified adjusted gross income (MAGI) to determine eligibility for savings. It's not a line on your tax return. Your total (or “gross”) income for the tax year, minus certain adjustments you're allowed to take.
To be eligible for the premium tax credit, your household income must be at least 100 percent and, for years other than 2021 and 2022, no more than 400 percent of the federal poverty line for your family size, although there are two exceptions for individuals with household income below 100 percent of the applicable ...
The amount of APTC you'll have to repay will depend on how much excess APTC was paid on your behalf, your household income, and your tax filing status. If your household income (MAGI) is at least 400% of the previous year's federal poverty level (FPL), you'll have to repay all of the excess APTC.
| Health insurance plan member | Average monthly cost for an HMO plan | Average monthly cost for a PPO plan |
|---|---|---|
| Adult individual age 21 | $342 | $404 |
| Adult individual age 27 | $361 | $423 |
| Adult individual age 30 | $390 | $458 |
| Adult individual age 40 | $438 | $516 |
Recent President Donald Trump signed the Tax Cuts and Jobs Act in 2017. This bill repealed the tax penalty mandate from the ACA. Therefore, Obamacare tax penalties are no longer in effect on a federal level as of 2019 and onwards. However, several states still mandate tax penalties for not having health insurance.
If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit. Refer to glossary for more details. your premium tax credit.
If you use more advance payments of the tax credit than you qualify for based on your final yearly income, you must repay the difference when you file your federal income tax return. If you use less premium tax credit than you qualify for, you'll get the difference as a refundable credit when you file your taxes.
Income, household size and affordable coverage
Under the Affordable Care Act, eligibility for subsidized health insurance is calculated using a household's Modified Adjusted Gross Income (MAGI).
The tax applies only to people with relatively high incomes. If you're single, you must pay the tax only if your adjusted gross income (AGI) is over $200,000. Married taxpayers filing jointly must have an AGI over $250,000 to be subject to the tax.
How is Obamacare tax credit calculated?
The amount of the advance premium tax credit that people receive is based on a projection of the income the household expects for the year. The final amount of the credit is based on their actual income as reported on the tax return for the year the advance payment was received.
If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit. Refer to glossary for more details. ” when you file your federal taxes.
The Poverty Threshold in 2023
Under their guidelines, a family of four is considered impoverished if they earn $30,000 or less per year. That number is slightly higher in Alaska and Hawaii, which tend to have higher living expenses.
MAGI is adjusted gross income (AGI) plus these, if any: untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest. For many people, MAGI is identical or very close to adjusted gross income. MAGI doesn't include Supplemental Security Income (SSI).
| Household/ Family Size | 2024 Federal Poverty Level for the 48 Contiguous States (Annual Income) | |
|---|---|---|
| 100% | 400% | |
| 1 | $15,060 | $60,240 |
| 2 | $20,440 | $81,760 |
| 3 | $25,820 | $103,280 |
