What tribal employees need to know about the ACA, exemptions, and the IRS

The Basics:

The Affordable Care Act ensures, by law, that all U.S. citizens who are required to file taxes, have insurance or qualify for exemption.  There are two exemptions you may be eligible for to avoid a penalty for not having insurance coverage: 

• The American Indian/Alaska Native Exemption (AI/AN)

• The Hardship Exemption

You have to qualify to apply for these exemptions, or self-attest for the AI/AN, at the time of filing taxes.  Cherokee Nation has ACA trained Certified Application Counselors (CACs) available free of charge in all Cherokee Nation health centers  and W.W. Hastings Hospital to assist our tribal citizens and any non-Native household members in filling out the ACA application, enrollment and exemptions through the ACA Marketplace. These counselors will educate you on the opportunities given as special provisions for Native Americans in the Affordable Care Act, such as premium tax credits and cost-sharing benefits for affordable coverage. 

How Do I Know If I Need to File for an Exemption or Purchase Insurance through the Marketplace?

• If you have insurance through your employer (i.e. Cherokee Nation) – you are okay, no additional action is needed.

• If you have Medicare/Medicaid /SoonerCare/VA/ TriCare, or other state program coverage  – you are okay, no additional action is needed.

• If your spouse and children have insurance through employer coverage – they are okay, no additional action is needed.

Cherokee Nation has already helped more than 200 families with enrollment, coverage and exemptions. It is possible for you to apply for both the coverage and the exemption, and receive both.

 

Tax Time:

Rumors that if you are Native American all you have to do is show your CDIB card at tax time are NOT TRUE.  If you wait until it’s time to file your taxes to claim your AI/AN exemption, your only alternative is to self-attest (claim) you are American Indian/Alaska Native.  You, the taxpayer, will then be responsible to tell the tax preparer about your insurance situation and we will report it.  It will be your responsibility if an IRS audit happens and you don’t have proof for every member of your household claimed on the AI/AN exemption.

If you did not apply for the AI/AN exemption through the Marketplace and receive your Exemption Certificate Number confirming  proof of your AI/AN status, and you have to file this year as per self-attestation, we strongly recommend you apply through the Marketplace before or during tax year 2015, to avoid another possibility of an IRS Audit.

 

Again, the ACA states all U. S. Citizens who are required to file taxes must have insurance coverage.  Cherokee Nation tribal citizenship cards are not considered insurance coverage.  As a citizen of the Cherokee Nation or as a non-native household member you can contact your local Cherokee Nation Health Center or W.W. Hastings Hospital and ask to speak to the Patient Benefits Coordinator (a CAC) for help, education and assistance.

Next Year:

By tax year 2015, employers and insurance companies both on and off of the Marketplace will be issuing to you - a new form (listed below) that will show evidence of insurance coverage, month to month.  You, the tax payer, will need to bring this with you when filing taxes, for the 2015 tax year.  This will affect early tax filers, as this document, like W-2 forms, does not have to be issued until January 31, 2016. These three forms and their issuers are:

• The Marketplace Insurance Coverage – Form 1095-A

• Insurance Company Issuers  (off the Marketplace)  – Form 1095-B

• Employers Insurance Coverage – Form 1095-C