At press time, it appears that legislation to repeal and replace the Affordable Care Act (ACA) – including its taxes – will not be revisited until after Congress’ August recess. Although there have not been any legislative changes to the ACA, there could be administrative changes.

The ACA required an extensive outpouring of regulation to be implemented,” said Edward Leeds, Counsel of Ballard Spahr LLP, Philadelphia. ” Over the coming months, The Department of Health and Human Services (HHS) and other federal agencies will conduct a thorough review of these regulations, and we can expect to see new regulations proposed and other guidance provided. Many employer groups will look to see how reporting obligations are addressed, and there is considerable speculation about the enforcement position that the IRS will take with regard to the individual mandate and how that will affect the individual health insurance market.”


Earlier this year, the House passed the American Health Care Act, along party lines, to repeal and replace the ACA. GOP leaders in the Senate have tried, unsuccessfully, to advance several versions of ACA repeal legislation. Most recently, the Senate rejected a so-called “skinny” ACA repeal bill.

“Future legislation may address particular ACA provisions in a piecemeal manner. Elements of repeal or replace legislation may emerge in other bills, particularly when Congress takes up the subject of comprehensive tax reform. For example, Congress may further delay, modify, or repeal the so-called Cadillac tax when it is not presented as part of a larger-scale effort to dismantle the ACA,” Leeds observed.

IRS actions

During the 2017 filing season, the IRS announced that it would continue to process individual returns that do not report the taxpayer’s health coverage status under the ACA. The IRS had planned to reject these returns (known as “silent returns”) after having accepted them in past years. At this time, the IRS has not announced it plans for the 2018 filing season.

Cost sharing

Individuals who obtain coverage through the ACA Marketplace (Exchange) may be eligible for cost-sharing reductions. Reductions decrease annual out-of-pocket limits and, for lower-income individuals, further increase a plan’s share of total allowed benefits costs. The federal government pays issuers for the value of the reductions they make.

“The future of cost-sharing reductions presents perhaps the most immediate concern,” Leeds noted. “The subsidies were the subject of an ongoing battle between Congressional Republicans and the Obama Administration. The dispute ended up in federal court, where a judge ruled that HHS had no right to fund the cost-sharing reductions without a Congressional appropriation. That decision was stayed pending appeal, and the Obama Administration and, so far, the Trump Administration have continued to provide funds for the subsidies. The prospect that HHS and Congress will discontinue the subsidies now weighs heavily as insurers on the Exchanges determine the final rates that they will submit for 2018.”