What your health insurance decision means for your taxes (2024)

As a freelancer, electing whether or not you have healthcare coverage is a big deal. There’s obviously the impact on your own physical wellbeing and the out-of-pocket costs, but there’s also the impact on your taxes. So while open enrollment season is here, it’s worth taking stock of how your health insurance status may affect your freelance taxes.

Not having health insurance no longer means a federal tax fee. 2019 was the first year that the federal tax penalty (The Affordable Care Act’s individual Shared Responsibility Payment, or individual mandate) for not having coverage was eliminated since Obamacare brought it into effect — a fact you’ll see reflected on this year’s return, and those going forward. This fee was collected by the IRS from taxpayers who could afford health insurance but chose not to buy it.

However, you may still have a state penalty. While there isn’t a federal tax penalty for not having health insurance, some states are picking up the slack, so to speak. States including the District of Columbia, Massachusetts, and New Jersey have introduced a new individual health insurance mandate that requires you to have qualifying health coverage — or pay a fee in lieu of it — with your 2019 state taxes. In 2020, California and Vermont will have this mandate. There are several other states also considering this.

No health insurance in 2019? It may increase your taxable income. While not having health insurance won’t add to your tax bill this year or beyond, it will eliminate your ability to reduce your taxable income by deducting the cost of your health insurance premiums. This means that unless you have other deductions, you may need to factor in paying more in tax. Also, you will still be paying the same amount of Medicare and Social Security taxes.

If you have out-of-pocket medical expenses, don’t count on itemizing them. If you don’t carry health insurance, you know that you have to pay medical expenses out of pocket. However, with the increased standard deduction under tax reform (now at $12,000 instead of $6,500) unless you have a significant number of medical expenses, it’s likely not worth itemizing them.

If you did have a high number of significant healthcare bills this year, the medical expense deduction will help, but keep in mind that the floor for using it has risen again. Therefore you can deduct qualified medical expenses only when they are over 10 percent of your adjusted gross income for the year.

If you are hesitant about paying for health insurance because of the cost, it may be tax savvy to research some cheaper options. Experts predict that the Obamacare-era exchanges will still remain and offer reasonably-priced plans for now. In addition, the Trump administration’s proposal to expand the definition of what type of individuals or businesses can purchase ‘group” healthcare may create some less expensive, albeit less comprehensive, health insurance plans.

Consider a health savings account (HSA) if you have a high-deductible health insurance plan. If you decide to enroll in a high-deductible health insurance plan, you can use an HSA to set aside pre-tax dollars to pay for qualified medical expenses. In addition, there are time limits associated with using the funds in an HSA as well as stipulations on the specific items you can use the money for, so be sure to check with your plan administrator.

Make an informed decision about electing for health care coverage. Forgoing health insurance is a big decision for freelancers. If you feel that you can’t afford health insurance or that your out-of-pocket expenses will be less than what you might pay in premiums, then not having health insurance may save you a few dollars given that you will no longer be subject to a tax penalty for doing so—unless you live in a state that has instituted such a penalty. However, from a tax perspective, if have the misfortune of large medical bills, you are unlikely to see a tax win from a deduction standpoint if you opt out of an affordable health insurance plan and pay your bills yourself.

Whatever you ultimately do, be sure that you weigh all the factors involved in the cost vs. benefit analysis of paying for health insurance. That way you can know that your decision takes into account both your personal health needs and the health of your freelance business.

Jonathan Medows is a New York City based CPA who specializes in taxes and business issues for freelancers and self-employed individuals across the country. He offers a free consultation to members of Freelancer’s Union* and a monthly email newsletter covering tax, accounting and business issues to freelancers on his website, www.cpaforfreelancers.com — which also features a new blog, how-to articles, and a comprehensive freelance tax guide.

*Jonathan is happy to provide an initial consultation to freelancers. To qualify for a free consultation you must be a member of the Freelancers Union and mention this article upon contacting him. Please note that this offer is not available Jan. 1 through April 18 and covers a general conversation about tax responsibilities of a freelancer and potential deductions. These meetings do not include review of self-prepared documents, review of self-prepared tax returns, or the review of the work of other preparers. The free meeting does not include the preparation or review of quantitative calculations of any sort. He is happy to provide such services but would need to charge an hourly rate for his time.

What your health insurance decision means for your taxes (2024)

FAQs

How does health insurance affect your federal income taxes? ›

2022 health coverage & your federal taxes

You'll use IRS Form 8962 to do this. If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit.

Why does the IRS ask if you have health insurance? ›

The IRS is requiring anyone that purchased health insurance from healthcare.gov (or a state marketplace) to report their policy information to determine if the taxpayer qualified for the Advanced Premium Tax Credit.

Does the IRS still require proof of health insurance? ›

Please note that the Internal Revenue Service (IRS) or Franchise Tax Board (FTB) may require proof of your coverage by requesting a copy of your Form 1095-B. DHCS strongly suggests you keep your Form 1095-B for your records.

How does a 1095 affect my taxes? ›

If you receive a Form 1095-A, Health Insurance Marketplace Statement, showing that advance payments of the premium tax credit were paid for coverage for you or your family member, you must file an individual income tax return and submit a Form 8962 to reconcile those advance payments, even if you would not otherwise be ...

How does not having health insurance affect your tax return? ›

Penalty. You will have to pay a penalty, the Individual Shared Responsibility Penalty, when you file your state tax return if: You did not have health coverage. You were not eligible for an exemption from coverage for any month of the year.

What is a tax credit for health insurance? ›

A tax credit you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace ®. Your tax credit is based on the income estimate and household information you put on your Marketplace application.

Does the IRS penalize you for not having health insurance? ›

The ACA's federal tax penalty for not having minimum essential coverage was eliminated after the end of 2018, under the terms of the Tax Cuts and Jobs Act of 2017. Technically, the coverage requirement is still in effect, but there's no longer a federal penalty for non-compliance.

Can you get audited for not having health insurance? ›

You no longer will be penalized for not having health insurance. Before the TCJA change, you were subject to a penalty if you had a lapse in health insurance for a specific amount of time. You were required to answer questions about your healthcare coverage when you filed your tax return.

How much does the IRS tax you for not having health insurance? ›

The fee for not having health insurance (sometimes called the "Shared Responsibility Payment" or "mandate”) ended in 2018. This means you no longer pay a tax penalty for not having health coverage.

How much does IRS allow for health insurance? ›

Generally, you can deduct on Schedule A (Form 1040) only the amount of your medical and dental expenses that is more than 7.5% of your AGI.

How does IRS know if you have insurance? ›

Section 6056 requires employers that are ALEs under the employer shared responsibility provisions to file information returns with the IRS about whether they offered health coverage to their full-time employees (and their dependents) and, if so, information about the offer of coverage.

Do health insurance companies report to IRS? ›

What type of return must a health coverage provider file with the IRS? Generally, a health coverage provider must file Form 1094-B and Form 1095-B (or other form that IRS designates, or a substitute form).

Do you have to pay back tax credit for health insurance? ›

If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.

Does 1095-a lower your refund? ›

Yes. In some cases, the information on the corrected Form 1095-A may be in your favor – it may decrease the amount of taxes you owe or increase your refund. Taxpayers have the option of filing an amended return if they choose.

What happens if I don't put my 1095-A on my taxes? ›

The purpose of Form 1095-A is to reconcile any advance premium tax credits you received during the year with the amount of credits you were eligible to receive. If you fail to file a tax return reconciling those payments, you will not be eligible for premium tax subsidies in the next year.

Does medical insurance reduce federal tax? ›

Is health insurance tax-deductible? Health insurance premiums are deductible on federal taxes, in some cases, as these monthly payments are classified as medical expenses. Generally, if you pay for medical insurance on your own, you can deduct the amount from your taxes.

Do you pay federal taxes on health insurance premiums? ›

Employer-paid premiums for health insurance are exempt from federal income and payroll taxes. Additionally, the portion of premiums employees pay is typically excluded from taxable income. The exclusion of premiums lowers most workers' tax bills and thus reduces their after-tax cost of coverage.

Do health insurance premiums reduce taxes? ›

Health insurance premiums are deductible if you itemize your tax return. Whether you can deduct health insurance premiums from your tax return also depends on when and how you pay your premiums: If you pay for health insurance before taxes are taken out of your check, you can't deduct your health insurance premiums.

Do health insurance premiums reduce tax basis? ›

If your health plan is employer-sponsored, you'll be able to pay for premiums on a pre-tax basis, saving you money on income and payroll taxes. If you purchase your own individual plan, you'll have more flexibility but will pay more taxes.

Top Articles
Latest Posts
Article information

Author: Madonna Wisozk

Last Updated:

Views: 6199

Rating: 4.8 / 5 (68 voted)

Reviews: 91% of readers found this page helpful

Author information

Name: Madonna Wisozk

Birthday: 2001-02-23

Address: 656 Gerhold Summit, Sidneyberg, FL 78179-2512

Phone: +6742282696652

Job: Customer Banking Liaison

Hobby: Flower arranging, Yo-yoing, Tai chi, Rowing, Macrame, Urban exploration, Knife making

Introduction: My name is Madonna Wisozk, I am a attractive, healthy, thoughtful, faithful, open, vivacious, zany person who loves writing and wants to share my knowledge and understanding with you.