10 ZIP codes where the ACA individual mandate hit hard

September 02, 2016 at 05:51 AM
Share & Print

The Internal Revenue Service has started publishing the same kinds of detailed, consistent statistics for Affordable Care Act tax provisions that it publishes for the health savings account contributions and interest income.

The ACA premium tax credit program first came to life 2014. So did the individual health care "shared responsibility" system — the provision that requires many people to have what the federal government classifies as "minimum essential coverage," or solid health coverage, or else pay a penalty. 

The IRS released national 2014 summary data for the ACA tax programs Wednesday.

The IRS also posted county-level and ZIP code versions of the data.

The national summary numbers showed that 8.1 million taxpayers who filed individual returns, or about 5.9 percent of the 149 million filers, paid the penalty now imposed on many taxpayers who fail to show that they own minimum essential coverage for enough of the year. The penalty payments averaged about $210 per 2014 return.

We looked at the ZIP code-level data for clues about why so many people paid the penalty. The IRS filters out data for about 15,000 zones with few filers. But, in more than 4,000 of the 27,781 zones that are in the data files, no taxpayers reported owing the shared responsibility penalty for 2014. At the high end, in 198 ZIP codes, 15 percent or more of the filers said they owed responsibility penalty payments. The median is about 5.6 percent. 

The ACA and federal regulations created many exemptions from the individual penalty requirement, and special, broad exemptions that applied only for 2014. Consumers could have avoided paying the penalty legally, by, for example, joining health care sharing ministries, or illegally, by promising that they qualified for some types of exemptions that required no substantiation.

Some of the taxpayers who paid the penalties may have been unaware of the penalty system, or unaware of the many exemptions available. Some may have been so angry about the ACA that they went without health coverage simply to spite the Obama administration.

Some taxpayers may have paid the penalty because they had financial problems or personal characteristics that made scraping up enough cash to pay for coverage hard.

Still another driver could have been immigration issues. Consumers need to be able to show that they're in the United States legally to qualify for ACA premium tax credit subsidies. Some immigrants who do have a legal right to be in the country may have trouble documenting that. Others may be afraid of drawing attention to relatives who lack documentation of legal status.

A look at the ZIP code data suggests that lack of legal status and problems with documenting legal status are probably the main drivers: Nine of the 10 ZIP codes with the highest penalty rates are on the border with Mexico.

For a look at those 10 ZIP codes, along with YouTube videos showing a little of what those ZIP codes are like, read on:

Tecate, California, is right on the border with Mexico. Some residents may have immigration issues that interfere with their ability to get covered. (Video: Sandicor Virtual Tours/YouTube)

10. 91980

Tecate, California 

Number of individual returns: 960.

Number of returns with responsibility penalty due: 230.

Percentage of returns with responsibility penalty due: 24%.

Average penalty amount: $209.

Mission, Texas, is in Hidalgo County. Like Tecate, California, is across the border from Mexico. (Video: Century 21-TX/YouTube)

9. 78574

Mission, Texas 

Number of individual returns: 19,390.

Number of returns with responsibility penalty due: 4,650.

Percentage of returns with responsibility penalty due: 24%.

Average penalty amount: $217.

San Elizario, Texas, is in El Paso County along the Rio Grande. (Video: Gepar Virtual Tours/YouTube)

8. 79849

San Elizario, Texas 

Number of individual returns: 5,340.

Number of returns with responsibility penalty due: 1,300.

Percentage of returns with responsibility penalty due: 24%.

Average penalty amount: $192.

La Joya, Texas, in Hidalgo County. (Video: Century 21-TX/YouTube)

7. 78560

La Joya, Texas 

Number of individual returns: 1.960.

Number of returns with responsibility penalty due: 490.

Percentage of returns with responsibility penalty due: 25%.

Average penalty amount: $252.

Many of the year-round residents in Lake Powell, Utah, work in businesses that cater to tourists. (Video: Norbert982/YouTube)

6. 84533

Lake Powell, Utah 

Number of individual returns: 120.

Number of returns with responsibility penalty due: 30.

Percentage of returns with responsibility penalty due: 25%.

Average penalty amount: $100.

Roma is in Starr County, Texas. Like most of the other communities listed here, it's right across the border from Mexico. (Video: Joel Ramos/YouTube) 

5. 78584

Roma, Texas 

Number of individual returns: 7,340.

Number of returns with responsibility penalty due: 1,930.

Percentage of returns with responsibility penalty due: 26%.

Average penalty amount: $228.

Rio Grande City, Texas, is in Starr County, along the Mexican border. (Video: romo0012/YouTube)

4. 78582

Rio Grande City, Texas 

Number of individual returns: 14,140.

Number of returns with responsibility penalty due: 3,740.

Percentage of returns with responsibility penalty due: 26%.

Average penalty amount: $251.

Hidalgo is yet another community on this list that's in Hidalgo County, Texas. (Video: Century 21-TX/YouTube)

3. 78557

Hidalgo, Texas 

Number of individual returns: 6,200.

Number of returns with responsibility penalty due: 1,730.

Percentage of returns with responsibility penalty due: 28%.

Average penalty amount: $239.

Sullivan City, yet another community in Hidalgo County, has struggled with public safety issues in recent years. (Video: CBS 4 News Rio Grande Valley/YouTube)

2. 78595

Sullivan City, Texas 

Number of individual returns: 2,070.

Number of returns with responsibility penalty due: 610.

Percentage of returns with responsibility penalty due: 30%.

Average penalty amount: $208.

This Hidalgo County, Texas, community of Penitas was first settled in 1520. About 98 percent of its residents are Hispanic, according to Census Bureau data.

1. 78576

Penitas, Texas 

Number of individual returns: 3,760.

Number of returns with responsibility penalty due: 1,1600.

Percentage of returns with responsibility penalty due: 31%.

Average penalty amount: $233.

Related:

Have you followed us on Facebook

NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

Related Stories

Resource Center