Federal taxes and fees

  • The Federal Insurance Premium Tax. This annual tax funds subsidies on the Health Insurance Marketplace.
  • The Comparative Effectiveness Fee. This annual fee funds the Patient-Centered Outcomes Research Institute. The institute compares how well different medical treatments work.
  • The Reinsurance Fee. Health care reform guarantees coverage regardless of a person’s health status. The reinsurance program works to reduce the need for insurance companies to charge higher premiums because of that guarantee. The program transfers funds to individual insurance plans with higher-cost enrollees. The goal is to stabilize premiums during the early years of market reform.
  • The Marketplace Fee. The Affordable Care Act created a new way to shop online for health insurance. It’s called the Health Insurance Marketplace. This fee pays to support the Marketplace and has made it self-sustaining.
  • The Risk Adjustment Fee. This fee funds the risk adjustment program. The program helps to keep the cost of health insurance more stable.

State taxes

  • The Insurance Provider Assessment. The Insurance Provider Assessment requirements were effective on Oct. 1, 2018. The assessment helps fund the state Medicaid program.
  • The State Insurance Premium Tax. A tax on Michigan-based health insurance premiums.