Patient protection and affordable care act annual fee on health insurers congressional research service 1 annual fee on health insurers the patient protection and affordable care act aca pl 111 1481and the reconciliation act of 2010 pl 111 152 impose a fee on certain for profit health insurers starting in 2014. Established by section 9010 of the patient protection and affordable care act the health insurance tax is an annual fee charged to insurance companies providing health policy premiums the fee applies to individual policies small groups non self insured employers medicaid managed care medicare part d and medicare advantage. Section 9010 of the patient protection and affordable care act aca imposes a fee on each covered entity engaged in the business of providing health insurance for united states health risks the first filings were due from covered entities by april 15 2014 and the first fees were due september 30 2014 there was a moratorium on the fee for 2017 and there was a suspension on the fee for 2019 the fee was repealed for calendar years beginning after december 31 2020. Patient protection and affordable care act annual fee on health insurers congressional research service 1 annual fee on health insurers the patient protection and affordable care act aca pl 111 1481 and the reconciliation act of 2010 pl 111 152 impose a fee on certain for profit health insurers starting in 2014