Friday, April 18, 2014
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Requirement of "Minimal Essential Coverage" in the Affordable Health Care Act:

Will residents abroad have to subscribe or pay a tax?

Now that the Supreme Court has ruled that Obama's health care law is constitutional, you may have asked yourself: what is the status of AARO members who live outside the US and more particularly will they have to sign up for health care coverage in the US or risk having to pay the tax on non-subscribers, if they don't?

When AARO and its partners attended Overseas Americans Week in 2010, this question, among others, was on our minds. We pointed out to Congressional staffers that our members, since they don't reside in the US, should be exempt from the requirement to maintain minimal essential coverage there, the more so as we benefit from coverage in the foreign country of our residence. Although the text of the law is several times that of War & Peace, we are pleased to report that it does provide relief from the requirement of minimal essential coverage for 'individuals residing outside the US or in a Territory thereof'. {See Section 1501(f)(4)}

The exemption operates in a novel way, 'treating an individual as having minimal essential coverage for any month during which he/she has his/her tax home in a foreign country and who (being a citizen of the U.)(a) establishes that he/she is a bona fide resident in a foreign country for an uninterrupted period which includes a taxable year, or (b) is present in a foreign country for at least 330 full days in such a period.

This 'treatment' is illusory (since a foreign resident won't really have coverage in the US) but it seems clear enough that he/she will not have to pay the tax imposed on those who opt out of the system in any qualifying month of residence abroad. Problems of interpretation can arise, however, for individuals starting or ending an expatriation, who have not yet qualified as a foreign tax resident or who have, but whose status changes upon return to the US.

Members of the AARO Medical Insurance programs:

To all Members of AARO's health insurance programs:

After somewhat contentious negotiations with Swiss Life, our carrier, which lasted a month, your Insurance Committee is pleased to report that premium rises for 2014 have been limited to a 4% increase (not counting increases resulting from an age-group change). Negotiations started with Swiss Life insisting on a 12% increase, later reduced to 8%. It justified this rise by the two expensive hospitalizations incurred by two programs during the current period and by the growing average age of our insured population. AARO in turn argued that results in the previous two years did not justify such a large increase. Direct recourse to Swiss Life by your Committee resulted finally in the more moderate increase of 4%.

AARO members are not excessive consumers of medical products and services. However, hospitalization and medical costs are rising at rates greater than inflation in Europe and you should be mindful of this and remember that your behavior can affect the overall health of the programs.

Sincerely,

AARO Insurance Committee

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