Changes starting in 2013

Beginning in 2013, the itemized medical expense deduction floor will be raised from 7.5% to 10% in order to limit tax-subsidized medical expenses.

Estates and trusts will be required to pay a Medicare contribution tax of 3.8% on the lesser of either their undistributed net investment income, or of their adjusted gross income in surplus of $11,200 (the current highest tax bracket threshold).

In addition, a tax of 0.9% will be instated on earned income over $200,000 (for individuals) or $250,000 (for families). Individuals and families with income over these limits will be required to pay a Medicare contribution tax of 3.8% on the lesser of either their net annual investment income (including interest, royalties, dividends, rent, trade or business income, self-employment income, estates, trust and property), or of the amount of their annual gross income exceeding the $200,000 or $250,000 limit.

Starting in 2014

Beginning in 2014, small business owners will be able to buy health insurance for groups of over 100 employees via the SHOP insurance programs set up in 2011 (see Healthcare Changes for Small Business, part 2: 2010-2011). In 2014 and 2015 only, small businesses that purchase group health insurance plans through SHOP will receive a tax credit of 50% on these contributions.

Meanwhile, companies with over 50 employees will be penalized $2,000 annually for every employee who ends up on a government-subsidized health care plan rather than being covered by an employee plan. Most people who are not eligible for Medicaid, Medicare, other government-sponsored coverage, or some form of employer-provided health insurance will be required to maintain their own minimal coverage or pay a penalty.

Low income households – those with income levels between 100% and 400% of the Federal Poverty Line – will qualify for a refundable health insurance premium tax credit. The Federal Poverty Line is current set at $10,830 for an individual, $3,740 per additional person and $22,050 for a family of four.

Finally, corporations with assets of over $1 billion will be required to pay higher estimated tax payments in July, August, and September of 2014 as this figure is raised to 15.75%.

American healthcare is poised for some pretty radical changes over the next several years – changes that are relevant to everyone from the youngest child to the oldest retiree. If you’re a small business owner or an employee of a small business, you’re probably wondering whether the new laws and regulations will impact you. Read on to learn about potential changes to your insurance and healthcare premiums.

Changes Starting in 2010

The upcoming healthcare changes will be phased in over the next few years. Although the bulk of the new regulations are slated for 2011, 2013, and 2014, there are two significant changes taking place in 2010.

During the period of 2010-2013, as the new regulations are gradually introduced, qualified small business owners are eligible for a tax credit of 35% on their contributions to health insurance premiums for their employees. Known as the Small Business Health Care Tax Credit, this perk is available only to small business with fewer than 25 employees and average wages of less than $50,000 annually.

In addition, parents will now be permitted to include adult children (up to age 26) on the coverage offered by tax-qualified, employer-provided health plans.

Changes starting in 2011

From 2011-2015, small business employers will be eligible to receive federal funding if they provide their staff with wellness programs.

Small businesses will also be permitted to form collectives or alliances in order to purchase employee health insurance policies at better rates. The online programs that will make this possible, known as SHOP or Small Business Health Options Programs, will receive state-level funding from federal sources.

You can also expect to see some more specific changes to permissible medical expenses. The definition of qualified medical expenses will be altered to exclude over-the-counter medications. This affects all Health Savings Accounts (HSAs) and Archer Medical Savings Accounts (MSAs), as well as reimbursements through Health Flexible Spending Arrangements (Health FSAs) and Health Reimbursement Arrangements (HRAs). The annual limit on allowable medical expenses from flexible spending accounts will be capped at $2,500.

Finally, a “cafeteria plan,” which allows employees to pick and choose benefits as needed, will be introduced for small business staff and the self-employed beginning in 2011.

We’ll explore some more details on the upcoming healthcare changes in our next post.