Health
In a new article in the September issue of “Health Affairs,” the leading journal of health policy, researchers from the University of California, Berkeley, UCLA, and the Economic Policy Institute are calling for expanded educational efforts to ensure that consumers signing up for health coverage under the Affordable Care Act (ACA) take maximum advantage of possible tax credits while avoiding repayments to the IRS.
In “Large Repayments of Premium Subsidies May Be Owed to the IRS If Family Income Changes Are Not Promptly Reported,” researchers explain that subsidies for health insurance premiums offered under the ACA are classified as refundable tax credits.
These credits can be taken when taxes are filed or in advance, as reductions in monthly premiums. Recipients who take subsides in advance will receive tax refunds if their subsidies were too small, but will have to make repayments if their subsidies were too high.
The authors predict that many individuals will need to repay all or part of their insurance premium subsidy to the Internal Revenue Service if they fail to report income changes during the year.
The researchers estimate that if no income changes are reported during the year, 38 percent of subsidy recipients would owe repayments at the time they file taxes, with a median repayment of $857.
If all changes are reported and subsidies are adjusted in a timely manner, that number would fall to 23 percent with a median repayment of only $343.
The greatest risk is for subsidy recipients in families of four that make $95,000 a year or more – families that start off the year eligible for subsidies, but end up over the threshold.
The researchers recommend that the insurance exchanges educate consumers on the process and provide tools to help enrollees determine the advance subsidy amounts they should receive.
“The subsidy was designed to ensure access to affordable health care,” said Ken Jacobs, lead author of the article and chair of the Center for Labor Research and Education (CLRE) at the University of California, Berkeley. “Exchanges can take simple steps like educating consumers about how tax credits work, informing them about the importance of promptly reporting changes in income, family size or tax filing status, and through exploring additional methods of periodically reminding enrollees to report any changes that have occurred beyond what is already required under federal regulations.”
The article was co-authored by Economic Policy Institute Director of Health Policy Research Elise Gould; Dave Graham-Squire, a CLRE research associate; and Dylan Roby, a University of California, Los Angeles, assistant professor of health policy and management at the Fielding School of Public Health.
Roby also directs the Health Economics and Evaluation Research Program at UCLA’s Center for Health Policy Research.
Kathleen Maclay writes for the UC Berkeley News Center.
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SACRAMENTO – Bills authored by Assemblymember Mariko Yamada (D-Davis) and Sen. Fran Pavley (D-Agoura Hills) that address ongoing problems with resident and employee safety at California developmental centers and state hospitals are now headed to the governor’s desk.
Assembly Bill (AB) 602 and Senate Bill (SB) 651 received unanimous bipartisan support in both houses of the Legislature.
AB 602 requires employees at these state facilities to report serious assault and abuse incidents directly to outside law enforcement agencies within two hours.
Currently, those reports are only made internally within two days and reporting to outside law enforcement is not mandatory.
“The current internal process to report and investigate these violations is inadequate,” Assemblymember Yamada said. “These matters should be investigated by local law enforcement agencies to ensure that state hospital and developmental center residents have access to the same protections as those who do not reside in state institutions.”
To facilitate investigations at the state’s developmental centers and state hospitals, which provide care for the state’s most seriously disabled residents, the bill will also require local law-enforcement to participate in specialized training for interacting with these resident populations.
SB 651 by Sen. Pavley would require victims of suspected abuse in state centers for the developmentally disabled and state hospitals to receive forensic exams from trained investigators at independent facilities. Independent exams could be performed at state facilities if it is safer for the patient.
“This bill will protect vulnerable Californians from abuse and hold both perpetrators and state caretakers accountable,” Pavley said.
In 2012, the investigative media organization California Watch found that the Office of Protective Services (OPS), the state's internal security service housed at state hospitals and developmental centers, had left a large number of abuse and sexual assault incidents uninvestigated.
Earlier this year, the state auditor confirmed that OPS investigatory practices were substandard and noted that the agency had failed to implement recommendations from a 2002 attorney general report addressing many longstanding security issues.
Yamada, whose district includes the Sonoma Developmental Center and the Napa State Hospital where many of the most serious incidents have occurred, chairs the Assembly Select Committee on State Hospital and Developmental Center Safety.
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