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The Affordable Care Act and VA health care coverage

Accounting Support • Dec 29, 2020
The Affordable Care Act (ACA) plays a vital role in expanding access to coverage. It is also the health care law and was created to control health care costs and improve health
VA Healthcare and Affordable Care Act Compliance

The Affordable Care Act (ACA) plays a vital role in expanding access to coverage. It is also the health care law and was created to control health care costs and improve health care quality. Here are some important things you need to know about the ACA and your health coverage.

Do individuals have to pay penalties for not having health insurance?

From 2019, you will not be subjected to a penalty even if you don’t have health insurance.

ACA required all U.S. taxpayers to have health coverage that met a minimum standard until the end of 2018. This minimum standard was called the “minimum essential coverage” requirement. The residents that qualified for an exception were not subjected to a penalty for not having health coverage. The exception could be due to certain life events, financial status, or other factors. Even if they had affordable health coverage options, the residents who didn’t buy health insurance would be subjected to a penalty. While filing their taxes, they must have to pay a fee called “individual shared responsibility payment.” The named individual shared responsibility payment is also called penalty or individual mandate.

Through 2019, Congress changed the law for all plans. The individual shared responsibility payment no longer applies in the 2019 year’s plan. Individuals don’t need to pay penalties while filing taxes in April 2020.

Note: But it doesn’t apply to the individuals who don’t have coverage or an exemption in 2018. They may still have to pay a fee while filing their 2018 taxes in April 2019.

Does my VA health coverage meet the ACA’s minimum essential coverage requirement for 2018?

VA aims to provide health care to all Veterans so that they can improve their health and well-being. The individuals enrolled in VA health care meet the health care law coverage standards. They don’t have to take additional steps to do so. Individuals that are not enrolled in VA health care can apply at any time. If you were signed up for any of the following programs, your health coverage meets the 2018 minimum essential coverage requirement. While filing 2018 taxes, the individuals covering these programs in 2018 didn’t have to pay the fee. 

Individuals must have been enrolled in any of these programs to qualify for the exemption:

  • The VA health care program, or
  • CHAMPVA, or
  • SBHCBP (Spina Bifida Health Care Benefit Program), or
  • CHAMPVA through the Comprehensive Assistance to Family Caregivers Program, or
  • The Department of Defense TRICARE plan providing minimum essential coverage.

Does ACA change the VA health benefits?

No. The health care law doesn’t change the out-of-pocket costs or VA health benefits of any individual.

If I’m not signed up for VA, How can I get health coverage for 2019 now?

Though open enrollment for 2019 is over, you can get coverage through the Health Insurance Marketplace. In case if you have certain life changes or qualify for low-cost coverage through Medicaid, you can enroll or change plans. 

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