[Federal Register Volume 79, Number 134 (Monday, July 14, 2014)]
[Notices]
[Page 40763]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-16406]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Clarifications Regarding the Ryan White HIV/AIDS Program and 
Reconciliation of Advanced Premium Tax Credits Under the Affordable 
Care Act; Request for Comment

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services (HHS).

ACTION: Request for Public Comment on Reconciliation of Advanced 
Premium Tax Credits (APTC or premium tax credit) under the Affordable 
Care Act and the Ryan White HIV/AIDS Program (RWHAP).

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SUMMARY: HRSA's HIV/AIDS Bureau (HAB) recently released HAB Policy 
Clarification Notice 14-01, which requires RWHAP grantees and 
subgrantees that use program funds to purchase health insurance in the 
Marketplace to establish appropriate mechanisms to vigorously pursue 
any excess premium tax credit a client receives from the Internal 
Revenue Service (IRS) upon submission of the client's tax return. HRSA 
now seeks public comment on the operational feasibility for RWHAP 
grantees and subgrantees to implement a complementary policy that would 
allow RWHAP grantees and subgrantees to use RWHAP funds to pay the IRS 
any additional income tax liability a client may owe to the IRS solely 
based on reconciliation of the premium tax credit. In addition to 
general comments about the feasibility of implementing such a policy, 
HRSA would like feedback on the following issues related to this 
policy:
     Could this proposed policy be easily implemented by a 
grantee?
     What challenges would grantees and subgrantees face in 
implementing this proposed policy?
     Will grantees be able to conduct fiscal monitoring of this 
proposed policy? If so, what level of effort would be required?

DATES: Submit comments no later than August 13, 2014.

ADDRESSES: Comments should be submitted to [email protected] 
by August 13, 2014.

FOR FURTHER INFORMATION CONTACT: Theresa Jumento using the email above 
or by telephone at (301) 443-5807.

SUPPLEMENTARY INFORMATION: Many RWHAP clients with incomes between 100-
400 percent of the federal poverty level (FPL) who do not have minimum 
essential coverage may be eligible for an APTC to offset the cost of 
purchasing a qualified health plan through the Marketplace. The amount 
of the premium tax credit is based on the individual's income, family 
size, and the cost of the second-lowest cost silver plan available to 
them in the Marketplace. If an individual qualifies for a premium tax 
credit, the individual may choose to have some or all of the estimated 
premium tax credit paid in advance directly to the insurance company to 
lower the individual's monthly premium or can wait to get all of the 
premium tax credit when the individual files a tax return at the end of 
the year.
    Taxpayers will reconcile the APTC when they file their tax returns. 
Individuals will subtract the total of any APTC they receive during the 
year from the amount of the premium tax credit calculated on their tax 
return (i.e., ``actual premium tax credit''). If an individual received 
APTC that exceeds the actual premium tax credit for which the 
individual is eligible, the individual will owe that amount back to the 
IRS.
    It is important for RWHAP grantees and subgrantees to convey to 
clients the importance of reporting accurate income information on 
their Marketplace application and reporting to the Marketplace any 
income changes as these changes occur throughout the year. Other 
changes in circumstances that can affect the amount of an individual's 
premium tax credit, that should be reported as they occur, include: 
Marriage, divorce, birth or adoption of a child, other changes to 
household composition, and gaining or losing eligibility for 
government-sponsored or employer-sponsored health care coverage. 
Notifying the Marketplace about changes in circumstances will decrease 
the likelihood of a significant difference between the APTC payments 
and the actual premium tax credit. For example, if an individual winds 
up making more money than estimated on the Marketplace application, the 
individual could have to pay back some or all of the premium tax credit 
on their next tax return.
    It is possible that, despite RWHAP grantees' and subgrantees' best 
efforts to encourage clients to report changes in circumstances to the 
Marketplace during the year, a RWHAP client's actual premium tax credit 
is less than the APTC resulting in the client owing the difference to 
the IRS. HRSA is considering allowing RWHAP grantees and subgrantees to 
use RWHAP funds to pay the IRS any additional income tax liability a 
client may owe to the IRS solely based on reconciliation of the premium 
tax credit.
    Should such a policy be implemented, grantees and subgrantees would 
be responsible for establishing and maintaining policies and procedures 
for coordinating such payments to the IRS since RWHAP grantees and 
subgrantees are prohibited from making any direct payments to clients. 
HRSA seeks comment from the public regarding this proposed policy, 
particularly on whether this policy could be easily implemented by the 
grantees and subgrantees and what challenges grantees and subgrantees 
might face in implementing such a policy.

    Dated: July 3, 2014.
Mary K. Wakefield,
Administrator.
[FR Doc. 2014-16406 Filed 7-11-14; 8:45 am]
BILLING CODE 4165-15-P