Everything Expats Need to Know About the Affordable Care Act

Everything Expats Need to Know About the Affordable Care Act
Updated on December 12, 2023

The Affordable Care Act, also known as Obamacare, is a US tax provision that was designed to give affordable healthcare to all Americans. This tax provision applies to all US persons, of all ages, whether or not they live in the US.

What is Required Under the Affordable Care Act?

Under the Affordable Care Act, you and your family are required to have health insurance that meets the “minimum essential coverage” requirements either through your employer, through the Marketplace or a state run insurance purchasing site. As of January 1, 2019, you will no longer need to pay the individual shared responsibility payment if you or your family members fail to meet the minimum essential coverage requirement.

From 2014 to 2018, individuals who did not hold the qualifying coverage for the full tax year would be required to pay the individual shared responsibility payment unless they qualified for an exemption. This was essentially a tax that was imposed either on a per person basis or a percentage of family income, whichever was greater.

These requirements were particularly tricky for US expats, as US expats often don’t have US healthcare insurance, and most foreign health care plans do not qualify as “minimum essential coverage.”

Are There Any Exemptions to the Affordable Care Act?

Under certain circumstances, there are exemptions to the ACA requirements. And, most US expats automatically qualify for an exemption from the ACA penalties due to Foreign Earned Income Exclusion. If you qualify for the Foreign Earned Income Exclusion, then you are exempt from needing “minimum essential coverage.”

There are two ways to qualify for the Foreign Earned Income Exclusion either through the Physical Presence Test or the Bona Fide Resident Test. Please note, if you qualify for Foreign Earned Income Exclusion based on your dates living outside the US it does not mean that you have to or can claim Foreign Earned Income Exclusion. For example:

A US government employee living in Germany for the entire year of 2018 would normally qualify for the Foreign Earned Income Exclusion using the Bona Fide Resident Test, but US Government employees cannot claim the Foreign Earned Income Exclusion. In this case, since the taxpayer qualifies for the Bona Fide Resident Test, they can take the exemption from the ACA.

Additionally, there are some foreign health insurance plans that cover expats both inside and outside of the US which would qualify them as having “minimum essential coverage.” However, each plan would need to be carefully examined and would need to specifically state that it conforms to the ACA “minimum essential coverage” standards. It’s always best to check directly with your provider if you have any questions or concerns as to whether the plan conforms to ACA standards.

How Do I Document This Exemption?

Just like the Foreign Earned Income Exclusion, if you qualify for an exemption from the ACA you need to make sure that you note that on your tax return. The IRS will not assume that you qualify for an exemption just because you are filing a tax return with a foreign address or claiming the Foreign Earned Income Exclusion.

If you only qualify for a partial year foreign earned income deduction, you will need to make sure that you have “minimum essential coverage” for the part of the year that you don’t qualify for Foreign Earned Income Exclusion. This is generally the case if you move during the year either into or out of the US.

What Are the Penalties for Non-Compliance?

What if you don’t qualify for the exemption and don’t have healthcare as outlined by the ACA? As of 2019, you’ll no longer have to pay a tax at the federal level, but state taxes may still apply. Keep in mind that, prior to 2019, the individual shared responsibility payment still applies. So, if you need to file taxes for previous years, make sure to keep records of your health insurance during this time to avoid penalties.

When and Where Can You Get Coverage?

If your employer does not offer healthcare coverage, or their coverage does not conform to the ACA healthcare standards as “minimum essential coverage,” then you will need to purchase insurance through the healthcare marketplace during open enrollment.

This marketplace is an online service that allows you to choose your preferred level of coverage amongst approved providers. You would register through your resident state. As an expat, you may not have a true resident state, but if you do not qualify for the Foreign Earned Income Exlcusion, the IRS considers you a resident of a US state. Use the state that you have the best connection to, with family, property or other ties.

Open enrollment in the marketplace is only open for three months – November 1 through January 31. After January 31st, only those with life changing events (such as marriage, divorce, birth and death of family members) can make adjustments to their insurance coverage.

What If You Cannot Afford Coverage?

If you cannot afford healthcare coverage, you may qualify for a credit to help offset the premiums. This credit, called the Premium Tax Credit, can be paid directly to your healthcare provider or as a refundable credit on your tax return. The credit is based upon your income and family size.

As an expat, you are generally shielded from the penalties involving the ACA, but you should be aware of the guidelines as they change on a yearly basis. If you think you will need coverage in the upcoming year because you will not qualify for an exemption, plan ahead to see what your options are in the healthcare marketplace. For more information visit Healthcare.gov.

Have More Questions About the Affordable Care Act for Expats?

If you have any questions regarding requirements or exemption on the Affordable Care Act Tax Provision, don’t hesitate to contact us today. We get back to you within 1 business day!

Every expat should know these 25 things about US expat taxes. Find out for yourself.
  • Hidden
  • Hidden
  • Hidden
  • Hidden
  • Hidden
  • Hidden
  • Hidden
  • By entering your email, you agree to receive emails from Greenback. You may opt out at any time per our Privacy Policy.
  • Hidden
  • Hidden
  • Hidden
  • This field is for validation purposes and should be left unchanged.