CMS issued a final rule regarding eligibility requirements for certain Americans to avoid the health law's fines for not obtaining health coverage, at the same time the Internal Revenue Service released guidance regarding health insurance tax credits.
CMS' final rule, which takes effect Aug. 26, specifies Americans who do not qualify for Medicaid solely because the state in which they reside did not expand the program will not be fined a "shared responsibility payment" if they do not obtain health insurance due to a hardship exemption clause in the law. In addition, CMS addressed a controversial loophole in the hardship exemption requirements by clarifying that a family may qualify for a hardship exemption if the cost to insure the whole family is not affordable. Previously, a worker could be fined for not covering his or her family if individual coverage was deemed affordable, even if family coverage was not.
The IRS released guidelines in determining whether individuals may be eligible for financial aid to buy health insurance. Families who must undergo a waiting period before enrolling in the Children's Health Insurance Program may qualify for premium tax credits to purchase private insurance in that time. Also, most employees and their dependents who are offered coverage through work that doesn't meet minimum benefits levels required by the health law in 2014 are exempt from the shared responsibility fines until the plans expire during the 2014 calendar year.
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