Review your lectures. Then:
Identify, how many Americans remain uninsured despite the PPACA (Patient Protection and Affordable Care Act), using the most current scholarly resource available.
Identify how many Americans are currently signed up for and have paid premium for the PPACA.
Discuss the current cost to Americans in subsidies, which are financially supporting the PPACA. What is the current fine charged by the IRS to those without insurance and how much will it increase in 2016? Will this fine increase have a negative or positive impact? Explain why.
Review the following articles
Lurie, I. Z., & McCubbin, J. (2016). What can tax data tell us about the uninsured? evidence from 2014. National Tax Journal, 69(4), 883-904.
Impact of obamacare on coverage: Reduction in the number of uninsured. (2016). Congressional Digest, 95(3), 7.
Jost, T. S., & Pollack, H. A. (2016). Making health care truly affordable after health care reform. The Journal of Law, Medicine & Ethics, 44(4), 546-554. doi:10.1177/1073110516684785
To support your work, use your course and textbook readings
As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed at 300-500 words.
7Congressional Digest ■■■■■ www.CongressionalDigest.com ■■■■■ March 2016
From the U.S. Department of Health and Human Services,
Office of the Assistant Secretary for Planning and Evaluation
Data Point report Health Insurance Coverage and the Af-
fordable Care Act, September 22, 2015.
Impact of Obamacare on Coverage
Reduction in the Number of Uninsured
In March 2015, the U.S. Department of Health andHuman Services Office of the Assistant Secretary for Plan-
ning and Evaluation (ASPE) estimated that 16.5 million
uninsured people had gained health insurance coverage as
several of the Affordable Care Act’s (ACA) coverage provi-
sions took effect. Using updated data, ASPE now estimates
that 17.6 million uninsured people have gained health in-
Coverage gains refer to different sources of coverage,
including Medicaid, the Health Insurance Marketplace, and
individual market coverage; therefore, gains are not limited
to Marketplace-eligible individuals.
● 15.3 million adults gained health insurance coverage
since the beginning of open enrollment in October
2013 through September 12, 2015. Over that period,
the uninsured rate declined from 20.3 percent to 12.6
percent — a 38 percent (or 7.7 percentage point) re-
duction in the uninsured rate.
● 2.3 million additional young adults (aged 19 to 25)
gained health insurance coverage between the enact-
ment of the Affordable Care Act in 2010 and the start
of open enrollment in October 2013 due to the ACA
provision allowing young adults to remain on a parent’s
plan until age 26.
■ Uninsured Rates by Race and Ethnicity
The uninsured rate declined across all race/ethnicity
categories since the baseline period. There were greater
declines in the uninsured rate among African Americans and
Hispanics than among whites.
● Among whites, the uninsured rate declined by 6.0 per-
centage points, from a baseline uninsured rate of 14.3
percent to 8.3 percent, resulting in 7.4 million adults
● Among African Americans, the uninsured rate declined
by 10.3 percentage points, from a baseline uninsured
rate of 22.4 percent to 12.1 percent, resulting in 2.6
million adults gaining coverage.
● Among Hispanics, the uninsured rate declined by 11.5
percentage points, from a baseline uninsured rate of
41.8 percent to 30.3 percent, resulting in about 4.0
percent of adults gaining coverage.
■ Uninsured Rates by State
Medicaid Expansion Status
Health insurance coverage gains continued to be especially
strong in Medicaid expansion States.
● Expansion States experienced a decline in their unin-
sured rate of 8.1 percentage points, from an average
baseline of 18.2 percent to 10.1 percent.
● Non-expansion States experienced a decline in their un-
insured rate of 7.3 percentage points, from an average
baseline rate of 23.4 percent to 16.1 percent.
■ Uninsured Rates for Young Adults
Coverage gains for young adults aged 19 to 25 started in
2010 with the ACA’s provision enabling them to stay on
their parents’ plans until age 26. From the baseline period
through the start of open enrollment in October 2013, the
uninsured rate for young adults declined from 34.1 percent
to 26.7 percent, which translates to 2.3 million young adults
● Since October 2013, an additional 3.2 million young
adults aged 19 to 25 gained coverage.
Continued on page 32
32 Congressional Digest ■■■■■ www.CongressionalDigest.com ■■■■■ March 2016
Impact of Obamacare on Coverage
Continued from page 7
s● In total, an estimated 5.5 million young adults gained
coverage from 2010 through September 12, 2015,
which is statistically unchanged from March 4, 2015.
■ Uninsured Rates by Gender
The uninsured rate declined for both males and females
since the baseline period. There was a greater decline in the
uninsured rate among females than among males.
● Males experienced a decline in their uninsured rate of
7.3 percentage points, from an average baseline rate of
21.8 percent to 14.5 percent, resulting in 7.3 million
adult males gaining coverage.
● Females experienced a decline in their uninsured rate
of 8.1 percentage points, from an average baseline rate
of 18.9 percent to 10.8 percent, resulting in nearly 8.2
million adult women gaining coverage.
of fairer rules and stronger consumer protections
that have made health care coverage more afford-
able, more attainable, and more patient centered.
And it is working. About 17.6 million Americans
have gained health care coverage as the law’s cover-
age provisions have taken effect. The Nation’s un-
insured rate now stands at its lowest level ever, and
demand for Marketplace coverage during Decem-
ber 2015 was at an all-time high. Health care costs
are lower than expected when the law was passed,
and health care quality is higher — with improve-
ments in patient safety saving an estimated 87,000
lives. Health care has changed for the better, setting
this country on a smarter, stronger course.
The Reconciliation Act would reverse that
course. The Congressional Budget Office estimates
that the legislation would increase the number of
uninsured Americans by 22 million after 2017. The
Council of Economic Advisers estimates that this
reduction in health care coverage could mean, each
year, more than 900,000 fewer people getting all
their needed care, more than 1.2 million additional
people having trouble paying other bills due to
higher medical costs, and potentially more than
10,000 additional deaths. This legislation would
cost millions of hard-working middle-class families
the security of affordable health coverage they de-
serve. Reliable health care coverage would no longer
be a right for everyone: it would return to being a
privilege for a few.
The legislation’s implications extend far beyond
those who would become uninsured. For example,
about 150 million Americans with employer-based
insurance would be at risk of higher premiums and
lower wages. And it would cause the cost of health
coverage for people buying it on their own to sky-
The Reconciliation Act would also effectively
defund Planned Parenthood. Planned Parenthood
uses both Federal and non-Federal funds to provide
a range of important preventive care and health ser-
vices, including health screenings, vaccinations, and
check-ups to millions of men and women who visit
their health centers annually. Longstanding Federal
policy already prohibits the use of Federal funds for
abortions, except in cases of rape or incest or when
the life of the woman would be endangered. By
eliminating Federal Medicaid funding for a major
provider of health care, H.R. 3762 would limit ac-
cess to health care for men, women, and families
across the Nation, and would disproportionately
impact low-income individuals.
Republicans in the Congress have attempted to
repeal or undermine the Affordable Care Act over
50 times. Rather than refighting old political battles
by once again voting to repeal basic protections that
provide security for the middle class, Members of
Congress should be working together to grow the
economy, strengthen middle-class families, and cre-
ate new jobs. Because of the harm this bill would
cause to the health and financial security of millions
of Americans, it has earned my veto.
Outlook. The House failed, by a vote of 241 to 186, to
sustain the President’s veto. Opponents of the law have
vowed to continue to work for repeal. “The idea that
Obamacare is the law of the land for good is a myth,” stated
Speaker of the House Paul Ryan. “This law will collapse
under its own weight, or it will be repealed.”
Continued from page 9
Copyright of Congressional Digest is the property of Congressional Digest and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
holder’s express written permission. However, users may print, download, or email articles for
National Tax Journal, December 2016,69(4), 883-904 https://doi.O rg/10 .1 7310 /n tj.2 0 1 6.4.08
W H A TC A NTA X DATA TELL US A B O U TT H EU N IN S U R E D ?
E V ID E N C EF R O M2 0 1 4
Ithai Z. Lurie and Janet McCubbin
About 14 percent o ffam ilies that file dtax returns fo r2014 reported a spell o f
uninsurance fo rat least one fam ily member. Uninsurance rates were higher fo r
young adults, unmarried persons, low-income families, and fam ilies in states that
did not expand eligibility fo rMedicaid. These results are generally consistent with
estimates fromsurvey data. M any fam ilies who were uninsured in 2014 appear
eligible fo rM edicaid or Premium Tax Credits. Outreach to these fam ilies coidd ef
fectively reduce the number o funinsured. Better data fo r2015 and later years will
allow fo rmore comprehensive and detailed estimates about uninsured Americans.
Keywords: ISRP, exemption, uninsured
JEL Codes: H22, H24,113
he Affordable Care Act o f 2010 (ACA) intersects with the tax system in several
ways. Most importantly, the ACA created subsidies, including the Premium Tax
Credit (PTC), to help low- and moderate-income people obtain affordable health insur
ance. The AC A also requires individuals to obtain health insurance coverage, receive an
exemption from the coverage requirement, or pay a penalty. In addition, large employers
that do not provide affordable coverage to full-time employees may owe an assessable
payment if one or more full-time employees receive the PTC.
In this paper we use tax return data to learn about the characteristics of the uninsured
in 2014. Data on the insured and uninsured can help us understand the efficacy of
subsidies and penalties in inducing health insurance coverage. In addition, information
about the reporting of insurance status will help the Internal Revenue Service (IRS)
improve tax forms and instructions. Information about the characteristics and behavior
of the uninsured will also help IRS and others to improve outreach efforts aimed at
Ithai Z. Lurie: O fficeo f Tax Analysis, U.S. D e p a rtm e n t o f theTreasury, W ashington, DC, USA (lthai.Lurie@
Janet M cC ubbin: O ffice o fTax Analysis, U.S. D e p a rtm e n t o f th eTreasury, W ashington, DC, USA (Janet.
M cC ubbin@ treasury.gov)
884 National Tax Journal
encouraging coverage. Finally, tax data on the uninsured can corroborate and supple
ment survey data about health insurance coverage —data that are widely used for tax
expenditure modeling and myriad other purposes.
We find that 14.5 percent of families that filed tax returns for 2014 reported a spell of
uninsurance for at least one family member. Uninsurance rates were higher for young
adults, unmarried persons, low-income families, and families in states that did not
expand eligibility for Medicaid. These results are generally consistent with estimates
from survey data. Many families who remained uninsured in 2014 appear to be eligible
for Medicaid or PTC. Outreach to these families could effectively reduce the number
o f uninsured. Our findings to date are tentative, because information about insurance
status on 2014 returns is limited. Better data for 2015 and later years will allow for
more comprehensive and detailed estimates about uninsured Americans.
Taxpayers who have full-year coverage for all of the individuals on their tax returns
report this by checking a box on Form 1040. Tax return filers who are uninsured any
part o f the year, or who have a dependent who is uninsured for any part of the year,
may claim exemptions from the health coverage requirement on Form 8965. Taxpayers
who do not have coverage for themselves or for a dependent for at least one month, and
who do not claim an exemption, report the individual shared responsibility payment
(i.e., the penalty) on Form 1040. In this paper we use tax year 2014 data to examine
the characteristics o f tax return filers in 2014. Specifically, we analyze the population
o f tax year 2014 returns processed by IRS through March 2016. We define uninsured
families or persons as those who claim an exemption from the health care coverage
requirement or who pay a penalty for failure to have coverage or both for at least one
Taxpayers are responsible for providing coverage, claiming exemptions, and receiving
PTCs for themselves and for any person they may claim as a dependent. Dependents
generally do not report on their own health insurance status, even if they file tax returns.
Thus, we exclude returns filed by dependents from our analysis and define a tax family
as a non-dependent return, including the primary and secondary filers and all dependents.
Relying on tax return data creates analytical challenges and important limitations
to our findings. First, because insurance status was not reported on tax returns before
2014, we cannot show the effect o f the AC A on coverage.1 Second, the 2014 data are
largely self-reported, and taxpayers face incentives to over-report coverage. However,
we find several indications that the self-reported data are largely accurate. Third, our
data are limited to families that file tax returns, and exclude the approximately 10 percent
1 Data from the Current Population Survey and other sources find that rates o f uninsurance fell significantly
between 2013 and 2014, in a manner that is consistent with the intent of the ACA (Smith and Medalia,
What Can Tax Data Tell Us about the Uninsured? Evidence from2014 885
of the U S. population (including 7 percent o f the non-elderly population) that does
not appear on an income tax return. Lastly, the tax return data do not provide insur
ance status for each person or the duration of any spell of uninsurance; in many cases
we know only that at least one family member was uninsured for at least part of the
III. EXEMPTIONS FROM THE COVERAGE REQUIREMENT
Exemptions from the coverage requirement are available for several specific cir
cumstances provided under the statute and for general hardship, as determined by the
Marketplaces (under the purview o f the Department o f Health and Human Services).3
Some exemptions are granted only by the Marketplaces, some are claimed only on the
tax return, and some can be taken in either way.
Exemptions granted by the Marketplace are reported to IRS by the Marketplace and
reported by tax return filers on Part I of Form 8965. The data reported to IRS by the
Marketplace include the specific individual and months for which each exemption applies
and the type o f exemption. In 2014, nearly all Marketplace exemptions reported to IRS
were applicable for the full year. Exemptions that may be granted by the Marketplace
include those for: general hardship (e.g., bankruptcy, fire, homelessness, death of a
family member); unaffordable coverage based on projected income;4 membership in a
religious sect that objects to accepting insurance benefits; individuals unable to renew
2013 coverage; and certain other exceptions available only for 2014.
Exemptions that may be claimed only on the tax return are reported in Parts II or
III of Form 8965. These include exemptions for. income below the filing requirement
(but nevertheless filing a tax return);5 unaffordable coverage, based on actual income or
2 More complete information will be available for future years. To facilitate IR S’s administration o f the
ACA tax provisions and to help taxpayers correctly report on their coverage status, insurers and employ
ers provide information about health coverage to enrollees and to IRS. This information includes the type
o f coverage and months o f coverage for each person enrolled in insurance that meets the ACA coverage
requirement. Coverage through a health insurance Marketplace (which is required in order to obtain the
PTC) is reported by the Marketplaces on Form 1095-A. Large employers report offers o f coverage and
enrollment in self-insured plans on Form 1095-C. Other insurers, government health programs, and small
employers providing self-insured coverage report monthly enrollment for each person on Form 1095-B.
While Marketplace data are available for 2014, employer and insurer reporting on Forms 1095-B and C
did not begin until this year, for coverage in tax year 2015.
3 See Internal Revenue Code §5000A, 45 CFR 155.605 and 26 CFR 1,5000Afor the health insurance cover
age requirement, penalty calculation, and exemptions.
4 The exemption for coverage unaffordable based on projected income is allowed: (1) if an individual is
eligible for employer-sponsored coverage but the required employee contribution for the coverage exceeds
8 percent o f projected household income for the year; or (2) if the required contribution (after accounting
for PTC) for the lowest-cost bronze Marketplace plan that would cover all family members who are not
eligible to purchase employer-sponsored coverage or have not received another exemption exceeds 8
percent of projected household income.
5 Families who do not file tax returns do not need to claim exemptions.
886 N a t io n a l T a x J o u r n a l
based on aggregate self-only coverage;6 citizens living abroad or certain non-citizens;
short gaps in coverage o f three months or less; and a few other exceptions that apply
in 2014 only.
Some exemptions may be granted by the Marketplace (in which case they may be
reported in Part I of Form 8965) or claimed on the tax return (in which case they are
reported in Part III of Form 8965). These include exemptions for: income below 138
percent of the Federal poverty level (FPL) and resident of a state that did not expand
Medicaid; member of a health care sharing ministry; member of an Indian Tribe or
recipient o f Indian Flealth Services care; and incarceration.
Exemptions are generally reported for each person and each month, and we provide
results for both families and individuals below. However, the exemption for having
income below the filing requirement applies to the entire tax family for the entire year,
and uninsurance for specific family members or months is not reported. Therefore, we
categorize every person on a tax return with this exemption as exempt and uninsured
for the entire year when analyzing the data at a person-level. Interpreting every person
who qualifies for this exemption as uninsured will overstate the number o f uninsured
Individuals may be eligible for more than one type of exemption for a given month,
and in some cases are instructed to report all of the exemptions for which they qualify.
However, taxpayers are not required to determine or report all of the exemptions for
which they qualify. Therefore, we use an ordering rule to place individuals in mutually
exclusive categories o f the type o f exemption used. We first identify who claims the
exemption for having income below the filing requirement, followed by those who
have low incomes and reside in a state that did not expand Medicaid, citizens abroad
and certain non-citizens, persons with a short-coverage gap, persons with unaffordable
coverage, and other exemptions. Placing persons in mutually exclusive categories sim
plifies the analysis. But as a result, the exemption for having income below the filing
requirement will appear more frequently and the exemption for unaffordable coverage
less frequently than would be the case if we used a different ordering rule or none at all.
In addition, some codes used on Form 8965 may refer to more than one type of
exemption. In particular, code “G” may indicate that coverage is unaffordable based on
aggregate self-only coverage that the individual has low income and resides in a state
that did not expand eligibility for Medicaid, or that other special cases for 2014 apply.
We assume that a code G on a return with income below 138 percent of the poverty
level filed from a state that did not expand Medicaid is explicitly for that exemption and
that the remaining code G entries indicate that coverage was unaffordable.
6 The exemption allowed because coverage is unaffordable based on actual income is similar to that de
scribed in footnote 4 above, but is based on actual household income rather than projected income. The
exemption for unaffordable aggregate self-only coverage is allowed for the year if for any month: (1)
the cost of employer-sponsored self-only coverage for two or more members is affordable when tested
individually, (2) the cost of employer-sponsored family coverage is unaffordable, and (3) the combined
cost of employer-sponsored individual coverage is unaffordable.
W h a t Can Tax D ata Tell Us a b o u t th eU n in s u re d ?E v id e n c efr o m2 0 1 4 887
IV. CALCULATION OF THE INDIVIDUAL PAYMENT RESPONSIBILITY
Taxpayers who are uninsured for all or part of the year (or who have an uninsured
dependent) and who do not qualify for an exemption from the coverage requirement
must make an individual responsibility payment. The amount of this payment, or pen
alty, depends on the number o f persons without qualifying health insurance coverage
per month, income, and the family’s filing threshold. Specifically, for 2014 the penalty
for each month is
(1) (l/12)xm ax|m in[95x(A ? x
|0 .0 8
0 .0 6
w0 .0 4
Income as a Share of FPL
states, citizens abroad and certain non-citizens, and lack o f affordable coverage options,
each accounting for about 15 percent o f exemptions claimed (Figure 8).
Most individuals claiming an exemption, 84 percent, claim to be exempt from the
coverage requirement for the full year. Again this is driven in part by the fact that, by
definition, income below the filing requirement qualifies every individual in the family
for an exemption for the entire year, even if the family had coverage for part of the year
or for some members of the family. However, most other exemptions are also claimed
for the entire year. The exceptions include exemptions for short coverage gaps, which,
by definition, should only be claimed for at most three months, and exemptions for
unaffordable coverage, about 43 percent o f which were claimed for the full year.
Persons who are not lawfully present in the United States are generally not eligible
for Medicaid or Marketplace health insurance coverage (though they may receive PTC
on behalf of a lawfully present dependent enrolled in coverage). These non-citizens as
well as citizens living abroad are exempt from the requirement to have health insur
ance coverage. People who need to file a tax return but do not have a Social Security
Number are issued an Individual Tax Identification Number, or ITIN, by IRS. Persons
with ITINs may reside outside the United States or they may be in the United States
898 National Tax Journal
F ig u re8
P e rc en t o fE x e m p t In d iv id u a lsb yT y p eo fE x e m p tio n
Type of Exemption
either lawfully or unlawfully. While we cannot observe who among ITIN-holders is not
lawfully present, we know that nearly all filers who are not lawfully present use ITINs.
ITIN holders, whether lawfully present or not, may have insurance through other means,
such as an employer, family member, or individual policy outside of the Marketplace.
However, we find that an exemption was claimed for almost half of persons with ITINs
on 2014 tax returns. Nearly 20 percent of persons claiming any type of exemption and
over 80 percent of individuals who claim an exemption for citizens abroad and certain
non-citizens are ITIN holders (Figure 9).
Over a quarter of exemptions are claimed for children under age 18 (Figure 10).
This surprised us, because subsidized coverage (namely Medicaid and the Children’s
Health Insurance Program) is more readily available for children. The most common
exemption claimed for children is for income below the filing requirement, and it is
possible that many of these children do have coverage, but appear on a return where
an adult is claiming this exemption for the entire family. We will know much more
about these children later this year, when Forms 1095-B showing enrollment in public
programs are filed with IRS. The second most common exemption for children is that
for citizens abroad and non-citizens.
What CanTax Data Tell Us about the Uninsured? Evidence from 2014 899
Percent o f Exemptions Claimed by Persons w ith ITINs, by Type
Type of Exemption
D istribution o f Individuals w ith Exemptions by Age
900 N atio na l Tax Journal
As other data show, the rate of uninsurance among adults generally falls with age.
The small uptick for elderly persons again appears to be attributable to persons on
a return with income below the filing requirement, where the exemption is perhaps
claimed on behalf of another uninsured family member, and to persons who are abroad
or are non-citizens.
Over half of people claiming exemptions have income below the poverty level, and
another 18 percent have income between 100 and 13 8 percent o f the poverty level (Figure
11). Individuals with incomes below 100 percent of the poverty level most often claim
the exemption for income below the filing requirement. Those with incomes between
100 and 138 percent of the poverty level most often claim the exemption for low-income
persons in states that did not expand Medicaid. In contrast, people with incomes above
138 percent o f the poverty level most often claim the exemption for unaffordable cover
age. Lastly, we find that about 7 percent o f individuals who claimed an exemption for
2014 have Marketplace coverage in 2015. This includes about 15 percent o f those with
incomes between 100 and 200 percent of the poverty level (Figure 12).
D istrib u tio no f Individuals w ithExem ptions b y FPL
<0 JZCO 0.10 0.0 0 ✓ I I i £>
Income as a Share of FPL (l/FPL)
W h a tC a nT a xD a t aT e ll U sa b o u tt h eU n in s u r e d ?E v id e n c ef r o m2 0 1 4 901
Percent of Individuals with Exemption in 2014That Have Marketplace
Coverage in 2015 By Fpl
Income as a Share of FPL (l/FPL)
VI. CONCLUSION AND NEXT STEPS
For 2014,19.7 million families reported at least one month o f uninsurance for at least
one family member. This amounts to 14.5 percent o f the 135.5 million families who
filed 2014 returns. Of these 19.7 million families 11.7 million claimed an exemption
only, 7.2 million paid a penalty only, and 0.8 million reported both for tax year 2014.
Information about uninsured families and individuals gleaned from tax data for 2014
is generally consistent with survey and other administrative data. Census data for 2014
suggest that nearly 12 percent o f individuals in the United States were uninsured at the
time they were surveyed and 10.4 percent were uninsured all year, compared to our
estimate o f 14.5 percent of families filing tax returns reporting a spell o f uninsurance.
We find that rates of uninsurance are higher for unmarried persons, younger adults,
lower-income families, persons residing in states that did not expand eligibility for
Medicaid, and certain immigrants.
At least 56 percent o f families who paid a penalty did so for all 12 months of the
year (for all or part of the family). Among single filers who paid a penalty, at least 68
902 N ational Tax Journal
percent were uninsured all year. Similarly, most individuals who claimed exemptions
did so for the full year. However, this result is largely driven by the fact that the most
common exemption, that for income below the filing requirement, by definition applies
all year and the particular months o f uninsurance or persons uninsured are not reported.
Both the consistency with survey data and some of the patterns o f responses suggest
that most taxpayers reported their insurance status correctly. For example, most people
claiming the exemption for citizens abroad and certain non-citizens have ITINs. Most
people claiming the exemption for persons below the filing requirement have low
Our findings about the characteristics of the uninsured suggest that many of them are
eligible for Medicaid or subsidized Marketplace coverage. About 37 percent of unin
sured families have incomes below 100 percent of the poverty level, 16 percent have
incomes between 100 and 138percent of the poverty level,and 18 percent have incomes
between 138 and 200 percent o f the poverty level. While some o f these families are not
lawfully present or are poor residents of states that did not expand Medicaid, most are
not and additional outreach to these families could encourage them to obtain coverage.
Thus, the Departments of Treasury and Health and Human Service are partnering
to send notices to taxpayers who paid a penalty or claimed an exemption for tax year
2015 and appear to be eligible for Medicaid or Marketplace coverage, during the next
Marketplace open enrollment period. Several notices will be tested in a randomized
controlled study, so that effectiveness of various messages can be measured.
Because we are relying on self-reported tax return data, some o f which is reported
only at a family or annual level, we do not currently have comprehensive information
on types o f coverage, the number of persons with coverage, or the duration of uninsur
ance. This information is important for administering a number of AC A provisions. It
is also important for understanding key tax subsidies for health insurance, including
the premium tax credit and exclusion of employer-sponsored health benefits. Fortu
nately, beginning with tax year 2015, we will have much better information on types of
coverage by person and month. The Office of Tax Analysis will soon be incorporating
person-month level information into our Individual Tax Model.
ACKN O W LED G M EN TS A N DDISCLAIMERS
This paper does not necessarily represent the views of the Department of the U S.
Treasury. The authors would like to thank Nathan Born for excellent work with final
edits to the paper. We would like also to thank participants in the National Tax Asso
ciation 2016 Spring Symposium and participants in a presentation at the Office of Tax
Analysis for their insightful comments.
The authors have no financial arrangements that might give rise to conflicts o f interest
with respect to the research reported in this paper.
W hat Can Tax Data Tell Us about the Uninsured? Evidence from2014 903
Council o f Economic Advisers, 2016. “The Affordable Care Act at Six: Progress on Cover
age, Costs, and Quality.” Presentation, March 22. Council o f Economic Advisers, Washing
ton, DC, https://www.whitehouse.gov/sites/default/files/page/files/20160322_aca_six_year_
Internal Revenue Service, 2014. “Revenue Procedure 2014-46.” Internal Revenue Service,
Washington, DC, https://www.irs.gov/pub/irs-drop/rp-14-46.pdf.
Internal Revenue Service, 2016. Letter from Commissioner John Koskinen (January 8). In
ternal Revenue Service, Washington, DC, https://www.irs.gov/pub/newsroom/irsJetter_aca_
Smith, Jessica C , and Carla Medalia, 2015. “Health Insurance Coverage in the United States:
2014.” Current Population Reports P60-253. U S. Census Bureau, Washington, DC, https://www.
Copyright of National Tax Journal is the property of National Tax Association and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
holder’s express written permission. However, users may print, download, or email articles for
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