Understanding Low-Income Assistance Options for ACA Health Insurance

The Affordable Care Act (ACA) provides a range of low-income assistance options to help individuals and families get affordable health insurance coverage. These options can significantly reduce the cost of health insurance premiums and out-of-pocket expenses, making it easier for low-income individuals to access the healthcare they need.

ACA Premium Tax Credits

The ACA provides premium tax credits to help low- and moderate-income individuals and families afford health insurance coverage purchased through the Health Insurance Marketplace. These tax credits are available in the form of a monthly payment that goes directly to the insurance company to reduce the cost of premiums.

Eligibility for premium tax credits is based on the following factors:

• Household income
• Number of household members
• Age
• State of residence

To qualify for premium tax credits, individuals and families must have an income that falls within a certain range. This range is based on the federal poverty level (FPL) and varies depending on the number of household members. For 2023, the income limits for premium tax credits are:

Household Size Annual Income Limit (FPL%)

1 $13,590 (100%)

2 $18,330 (133%)

3 $23,070 (167%)

4 $27,810 (200%)

5 $32,550 (234%)

6 $37,290 (269%)

7 $42,030 (304%)

8 $46,770 (339%)

Once you have determined if you are eligible for premium tax credits, you can apply for them through the Health Insurance Marketplace.

ACA Cost-Sharing Reductions

In addition to premium tax credits, the ACA also provides cost-sharing reductions to help low-income individuals and families reduce their out-of-pocket expenses for health insurance coverage. These cost-sharing reductions are in the form of lower deductibles, copays, and coinsurance.

Eligibility for cost-sharing reductions is based on the same factors as eligibility for premium tax credits. To qualify for cost-sharing reductions, individuals and families must have an income that falls within a certain range. This range is based on the FPL and varies depending on the number of household members.

For 2023, the income limits for cost-sharing reductions are:

Household Size Annual Income Limit (FPL%)

1 $20,370 (150%)

2 $27,090 (198%)

3 $33,810 (245%)

4 $40,540 (292%)

5 $47,260 (340%)

6 $53,980 (390%)

7 $60,700 (440%)

8 $67,420 (490%)

Once you have determined if you are eligible for cost-sharing reductions, you can apply for them through the Health Insurance Marketplace.

Medicaid Expansion

The ACA expanded Medicaid eligibility to low-income individuals and families in most states. Medicaid is a government-funded health insurance program that provides coverage for low-income individuals, families, and children. The ACA expansion made Medicaid available to individuals and families with incomes up to 138% of the FPL.

Eligibility for Medicaid expansion is based on the following factors:

• Household income
• Number of household members
• Age
• State of residence

To apply for Medicaid expansion, you can contact your state Medicaid agency.

How to Get Help with ACA Low-Income Assistance

If you need help with ACA low-income assistance, you can contact the following resources:

• Health Insurance Marketplace: The Health Insurance Marketplace is a government-run website where individuals and families can shop for health insurance coverage and apply for premium tax credits and cost-sharing reductions. You can visit the Marketplace website at HealthCare.gov or call the Marketplace call center at 1-800-318-2596.
• State Medicaid Agencies: State Medicaid agencies administer Medicaid programs in each state. You can contact your state Medicaid agency to apply for Medicaid expansion or other Medicaid programs.
• Local Health Departments: Local health departments can provide information about ACA low-income assistance programs and help you apply for coverage.
• Nonprofit Organizations: Many nonprofit organizations provide free or low-cost assistance with ACA enrollment and low-income assistance programs. You can find a list of these organizations at the National Association of Insurance Commissioners website.

By taking advantage of ACA low-income assistance options, you can make health insurance more affordable and accessible for you and your family.