Upload
hoang
View
48
Download
0
Tags:
Embed Size (px)
DESCRIPTION
Tax Preparers and Reaching the Eligible Uninsured. Stan Dorn, Senior Fellow The Urban Institute [email protected] 202.261.5561 Council for Electronic Revenue Communication Advancement May 21, 2014. s. Overview. Potential impact of tax preparers reaching the eligible uninsured Timing - PowerPoint PPT Presentation
Citation preview
URBAN INSTITUTE 1
Tax Preparers and Reaching the Eligible Uninsured
Stan Dorn, Senior FellowThe Urban [email protected]
202.261.5561
Council for Electronic Revenue Communication AdvancementMay 21, 2014
s
URBAN INSTITUTE 2
Overview
I. Potential impact of tax preparers reaching the eligible uninsured
II. TimingIII. A voluntary covenant
URBAN INSTITUTE 3
POTENTIAL IMPACT OF TAX PREPARERS ON REACHING THE ELIGIBLE UNINSURED
I.
URBAN INSTITUTE 4
Federal income tax filers, as a percentage of the uninsured who qualify for health coverage
Medica
id ch
ildles
s adu
lts
Medica
id pa
rents
Medica
id/CHIP ch
ildren
QHP subsi
dies
ALL ELIGIB
LE UNIN
SURED
53%
70% 72%88%
74%
2.3 million 3.1 million
9.7 million
18.9 million
3.8 million
Source: Dorn, Buettgens, Dev, 2014 (HIPSM-ACS). Notes: Estimates understate the prevalence of federal income tax filing as compared to administrative data.
URBAN INSTITUTE 5
Federal Income Tax Filing among the Uninsured Who Qualify for QHP Subsidies, by Age
0–18 19–34 35–44 45–64
94%90% 91%
84%2.0 million
3.1 million
Source: Dorn, Buettgens, Dev, 2014 (HIPSM-ACS). Notes: Estimates understate the prevalence of federal income tax filing as compared to administrative data.
0.4 million 4.2 million
URBAN INSTITUTE 6
Tax Preparation Method, by Adjusted Gross Income, 2008
AGI Total returns
(millions)
Tax preparation method
No identified preparer
Paid preparer
IRS-prepared
return
Volunteer income tax assistance
Tax counseling
for the elderly
Under $30,000
67.9 40.9% 55.8% 0.3% 1.5% 1.6%
$30,001-$50,000
25.4 41.7% 56.7% 0.1% 0.8% 0.8%
$50,001-$100,000
31.0 40.0% 59.1% 0.0% 0.3% 0.5%
>$100K 18.3 35.4% 64.4% 0.0% 0.1% 0.1%Total: 142.6 40.1% 57.8% 0.1% 0.9% 1.0%
Source: Dorn, Buettgens, Dev, 2014. Urban Institute Tax Policy Center analysis of IRS 2008 Statistics of Income.
URBAN INSTITUTE 7
Health program eligibility among various groups of EITC-eligible people (assuming Medicaid expansion)
Children Parents Childless adults TOTAL0%
25%
50%
75%
100%
95%
60%73% 79%
1%
12%
11% 7%
Medicaid/CHIP Marketplace subsidies
Source: Dorn, Isaacs, et al. 2013 (TRIM3, HIPSM 2012). Notes: Assumes that all states expand Medicaid eligibility for adults to 138 percent FPL.
URBAN INSTITUTE 8
Other benefits of engaging tax preparers
• Help completing paperwork• Leveraging the penalty for uninsurance at its
moment of maximum persuasive power– When it is being enforced to take away a refund
• Lowering monthly premiums– Average tax refund in the $20,000-$50,000 AGI range
exceeeds $2,700 per return– If some or all of the refund could be directed to pay annual
QHP premiums, more affordable coverage• Addressing tax reconciliation
URBAN INSTITUTE 9
TIMINGII.
s
URBAN INSTITUTE 10
Open enrollment 2015• November 15, 2014
through February 15, 2015– Previous proposed period ended
on 1/15/15• Modest overlap with tax filing
season possible• Families USA proposal
– Special enrollment through 4/15/15– If uninsured taxpayer pays penalty for
going without coverage in 2014, brief opportunity to enroll into QHP for 2015
URBAN INSTITUTE 11
Open enrollment 2016 and beyond
• HHS has now officially suspended judgment– Earlier proposal: 7 week open enrollment period,
mid-October through early December• Alternative calendar
– Open enrollment, 7 weeks ending on 3/31– Plan year starting on 5/1, ending 4/30
URBAN INSTITUTE 12
Pros and cons of alternative calendar Advantages• Can use tax preparers• QHPs seem more affordable in tax
refund season than holiday season • Carrier staff and brokers more
available when no overlap with ESI & Medicare open enrollment
• Less burden of employer verification. EINs allow verification by data match.
• Avoids perceived unfairness of forcing people to remain uninsured and pay penalty
Disadvantages• More complex tax
reconciliation• Need for transitional
QHP plan year• Some workers leave
ESI for QHPs mid-year, rather than in January
URBAN INSTITUTE 13
A VOLUNTARY COVENANTIII.
URBAN INSTITUTE 14
Issues• Challenges facing tax
preparers– Not much cooperation from
federal and state policymakers
• Concerns from a number of consumer groups about past activities of some unscrupulous for-profit tax preparers
URBAN INSTITUTE 15
Voluntary covenant concept• Policymakers offer tax preparers assistance they
need to efficiently and sustainably help numerous uninsured clients receive health coverage
• To qualify for that assistance, tax preparers can, if they wish, choose to live up to a “gold seal” code of conduct promulgated by leading health consumer groups
URBAN INSTITUTE 16
What assistance could best help tax preparers enroll numerous uninsured clients?
• Favorable publicity from, e.g., the Governor• “Back-end” data base forms that preparers could
populate with client data, eliminating the need to use websites to enroll clients into coverage
• Guaranteed acceptance of specific application forms
• Funding for successful Medicaid applications• What else?
URBAN INSTITUTE 17
Possible gold seal requirements1. Discounted tax preparation services for low-income
clients during open enrollment2. Competent tax preparation (e.g., fulfilling continuing
education requirements)3. Competent assistance with all health subsidy
programs, either directly or through a contractual partner
4. No loans for health insurance premiums (but can have full or partial refunds directed to help pay QHP premiums)
5. Either directly or through contractual partner—a. Certified navigators/assisters/brokersb. No additional charge for health applicationc. No preferential presentation of particular plans
URBAN INSTITUTE 18
Conclusion• Most eligible uninsured are not yet enrolled
in coverage• Tax preparers offer a remarkable chance to
reach the eligible uninsured• Taking advantage of that opportunity will
require close collaboration between policymakers, consumer groups, and the tax preparer community
URBAN INSTITUTE 19
Information sources• Stan Dorn, Matthew Buettgens, Jay Dev. “Tax Preparers Could Help Most
Uninsured Get Covered.” Prepared by the Urban Institute for the Robert Wood Johnson Foundation, Feb. 2014. http://www.urban.org/UploadedPDF/413029-Tax-Preparers-Could-Help-Most-Uninsured-Get-Covered.pdf
• Stan Dorn, Julia Isaacs, Sarah Minton, Erika Huber, Paul Johnson, Matthew Buettgens, and Laura Wheaton. “Overlapping Eligibility and Enrollment: Human Services and Health Programs Under the Affordable Care Act.” Prepared by the Urban Institute for the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Dec. 2013. http://www.urban.org/UploadedPDF/413028-Overlapping-Eligibility-and-Enrollment-Human-Services-and-Health-Programs-Under-the-Affordable-Care-Act.pdf.