Because of past fraud by rogue brokers, some Affordable Care Act policyholders may get an unexpected tax bill this season.
But that isn’t the only potential shock. Other changes coming soon — stemming from proposals by the administration of President Donald Trump — could affect their coverage and its cost. And sorting out related problems and challenges may take longer as federal workers are laid off and funding for assistance programs is cut.
First up: Taxes
Tax season is when some consumers learn they were fraudulently enrolled in an ACA plan or switched to a different one without their knowledge.
Those unauthorized enrollments or changes took off in late 2023 and continued through last year, drawing more than 274,000 complaints in the first eight months of 2024 to the Centers for Medicare & Medicaid Services, mostly about rogue agents or call centers.
Tax problems can arise if those enrollments resulted in premium tax credits exceeding the amount the consumer should have received. In those cases, consumers may have to pay all or part of those credits back. The amount owed could range from a few hundred dollars to thousands, with some caps based on income.
The first clue some people have is when they get a 1095-A form in the mail.
Those documents are sent out by the state and federal marketplaces to the IRS and ACA enrollees, showing any tax credit payments made to health insurers on a taxpayer’s behalf. Taxpayers use the premium tax credit information from …