The announced yesterday (Nov. 21, 2014) that it has made it easier for those subject to the Act to qualify for an exemption from the rule requiring that an either obtain or pay a penalty.
That rule, Internal Revenue Code Section 5000A, implements the “ Mandate” the Act, which requires every American to have for himself/herself and for any family member he or she claims as a .
Unless the or the qualifies for an exemption from this requirement, such as an exemption based on hardship, failure to comply exposes the to a penalty – the “ Mandate Penalty.”
The eased the rules how an certifies that he or she qualifies for a hardship exemption. Prior to the new regulation, individuals had to obtain a certification from a , as defined by 45 CFR 155.605(g).
The new regulation, 1.5000A-3(h), allows an to claim a hardship exemption without obtaining certification under any the following conditions:
(A) -sponsored is unaffordable. To qualify, the must fall into one three categories:
(1) the ’s required contribution for for himself or herself alone exceeds 8% household income,
(2) the combined required contribution for self-only for two or more employed members the ’s family exceeds 8% household income, and
(3) the required contribution for family in which the employed members the household could enroll through an exceeds 8% household income.
(B) Gross Income Below Filing Threshold. The has gross income below the income threshold for filing a return, and is not claimed as a another taxpayer.
(C) is obtained. The is (a) be enrolled in through the , (b) was “in line” to obtaining through the as March 31, 2014 or (c) was enrolled outside the for in effect May 1, 2014.
(D) Applied for CHIP. The applied and was eligible for Children’s (CHIP) during open for 2014 but had a gap in prior to the effective date CHIP .
(E) Indian Provider. The is eligible for services through Indian or an Indian healthcare provider.
(F) Non- Expansion State. The lives in a state that did not expand , and his/her household income is below 138% the federal poverty level for the ’s family .