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What the Affordable Care Act Means for Vets

Updated for Tax Year 2021 / October 16, 2021 02:30 AM


The Affordable Care Act is designed to provide all Americans with access to health insurance at reasonable rates, while working to lower costs, improving the quality of health care and improving the coordination of such care. Veterans have a few options to meet the terms of minimum essential coverage under the ACA.

The Affordable Care Act requirements

Beginning on January 1, 2014, Americans who do not qualify for an exemption are required to have minimum essential healthcare coverage. Minimum essential coverage includes many health insurance plans, such as employer-sponsored insurance, individual coverage purchased from the Health Insurance Marketplace and some types of health coverage offered through the Veterans Administration.

how does the affordable care act affect veterans

Qualifying VA healthcare programs

The Veteran's healthcare program, the Civilian Health and Medical Program and the spina bifida healthcare program, each administered by the VA, qualify under terms of the ACA as eligible programs, so if you’re already enrolled in one of these insurance types through the VA, you meet requirements for coverage. The ACA does not change any benefits you receive and your out-of-pocket costs remain the same. Enrolled vets will be notified by mail by the VA that there are no additional steps needed to comply with ACA standards.

How VA coverage affects other plans

VA coverage can be complemented with private insurance or other federal health insurance coverage, such as Medicare, Medicaid and TRICARE. The ACA does not affect or alter your VA coverage alone or in coordination with other plans. Most TRICARE plans, for example, meet minimum essential coverage requirements on their own. You can continue to use other health insurance if you are already covered, but there is no need to seek out additional coverage beyond qualifying VA plans to comply with ACA requirements.

VA coverage and other family members

Family members who are covered under their employers, TRICARE or some VA programs will also meet the ACA requirements for coverage. Those who are not already covered may want to investigate options through the Health Insurance Marketplace for coverage. They may be eligible for lower premiums, lower out-of-pocket costs, or they may qualify for low-cost or free coverage through Medicaid or the Children's Health Insurance Program. Family members covered under the CHAMPVA program also meet ACA coverage requirements.

The ACA and your tax return

The Affordable Care Act has no effect on tax returns for veterans with health coverage through a VA program. The premium tax credit applies to insurance obtained through the Health Care Marketplace, so it does not apply to VA coverage.

For tax years from 2014 through 2018, uninsured individuals who have affordable healthcare options and don’t meet the requirements for an exemption will pay a penalty under the individual shared responsibility provision. VA coverage may be considered an affordable option, if you’re eligible and don't enroll. Beginning in 2019 there is no longer a penalty for not having health insurance.

Not sure if you are exempt from the tax penalty or from the requirement to purchase health insurance? See "Are You Exempt From Health Care Coverage?" to help determine whether you might be eligible to waive the tax penalty entirely and apply for a health care exemption.

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