Dave Graham-Squire

Labor Standards for School Cafeteria Workers, Turnover and Public Program Utilization

I. INTRODU CTION .............................................................................. 447 II. B ACKGROUND ................................................................................ 448 III. WORKFORCE DEMOGRAPHICS ....................................................... 449 IV. SIMULATING SERVICE CONTRACT WAGE LEVELS........................ 451 V. SAVINGS FROM REDUCED TURNOVER............................................451 VI. SAVINGS FROM REDUCED PARTICIPATION IN PUBLIC SUPPORT PROGRAMS .................................... ...... 454 VII. OTHER SOURCES OF COST SAVINGS ................. ...... 457 VIII. SUMMARY ..................................... ..... 457

Large Repayments Of Premium Subsidies May Be Owed To The IRS If Family Income Changes Are Not Promptly Reported

Subsidies for health insurance premiums under the Affordable Care Act are refundable tax credits. They can be taken when taxes are filed or in advance, as reductions in monthly premiums that must be reconciled at tax filing. Recipients who take subsidies in advance will receive tax refunds if their subsidies were too small but will have to make repayments if their subsidies were too high. We analyzed predicted repayments and refunds for people receiving subsidies, using California as a case study. We found that many families could owe large repayments to the Internal Revenue Service at their next tax filing. If income changes were reported and credits adjusted in a timely manner throughout the tax year, the number of filers owing repayments would be reduced by 7-41 percent and the median size of repayments reduced by as much as 61 percent (depending on the level of changes reported and the method used to adjust the subsidy amounts). We recommend that the health insurance exchanges mandated by the Affordable Care Act educate consumers about how the subsidies work and the need to promptly report income changes. We also recommend that they provide tools and assistance to determine the amount of subsidies that enrollees should take in advance.

Health care reform in the US: an analysis of implementation of the Affordable Care Act in California

Background The Patient Protection and Affordable Care Act (ACA) was signed into law in 2010. In the past four years, federal and state governments have made changes to existing programs, created new ones, and attempted to foster innovation in the health care system. We provide an update on implementation of the ACA in California, specifically focused on the expansion of Medi-Cal for low-income populations and the creation of California’s marketplace to purchase insurance coverage.