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Health Care Reform:

Health Insurance & Affordable Care Act

WebMD News from Kaiser Health News

IRS Same-Sex Ruling Has Implications For Health Law

By Mary Agnes Carey

Fri, Aug 30 2013

Thursday’s announcement that the federal government will give the same tax treatment to legally married same-sex couples as they do to heterosexual couples may have ripple effects for the 2010 health care law.

The decision from the Treasury Department and the Internal Revenue Service means that the income of legally married same-sex couples will be considered in determining eligibility for enrollment in the health law’s Medicaid expansion and for subsidies to purchase coverage in the law’s online marketplaces, or exchanges.

The tax ruling applies regardless of whether the couple lives in a state that recognizes same-sex marriage, the agencies said.

Treasury officials did not offer estimates on what the decision would mean for the numbers of people who enroll in the exchanges or Medicaid, or the amount of subsidies the government would provide.

In a statement, Treasury and IRS officials also provided new guidance to people who get coverage for a same-sex spouse from their employer. The announcement said that coverage would no longer trigger income tax on the value of that coverage.

The ruling implements federal tax aspects of the June Supreme Court decision that invalidated a key provision of the 1996 Defense of Marriage Act.

“Today’s ruling provides certainty and clear, coherent tax filing guidance for all legally married same-sex couples nationwide,” said Treasury Secretary Jacob J. Lew. “It provides access to benefits, responsibilities and protections under federal law that all Americans deserve.”

One tax expert said the ruling could be a mixed bag for same-sex couples, and he urged them to consider their individual circumstances to determine if the announcement would help or hurt their ability to qualify for the health law’s subsidies or Medicaid.

In an analysis, Brian Haile, senior vice president for health policy for Jackson Hewitt Tax Service Inc., said same-sex partners who each have an income of $40,000 may be eligible for the health law’s tax credits individually, not if they get married. “If they marry, then they would lose eligibility because their income would be over the threshold for a household of two,” said Haile, who is based in Nashville, Tenn.

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