Is Your Family Eligible for ACA Subsidies? Understanding the Family Glitch

The Affordable Care Act (ACA) has been providing health insurance subsidies to low- and middle-income Americans for over a decade. However, a loophole known as the “family glitch” has prevented some families from receiving these subsidies. In this blog, we will explore the family glitch, its impact on ACA subsidies, and what options are available for families affected by it.

What is the Family Glitch?

Under the ACA, families are eligible for subsidies if their income is below a certain level and their health insurance premiums are above a certain percentage of their income. However, there is an exception to this rule for families in which one spouse has access to employer-sponsored health insurance that is affordable. Affordable in this context means the employee-only premium is less than 9.5% of the family’s household income. If the employer-sponsored insurance is affordable, the family is not eligible for subsidies regardless of the cost of the family plan.

Impact of the Family Glitch

The family glitch has prevented many families from receiving ACA subsidies, even if their income and health insurance costs qualify them for assistance. This is because many employers offer affordable employee-only coverage but not affordable family coverage. As a result, families are forced to pay the full cost of the family plan, which can be a significant financial burden.

Options for Families Affected by the Family Glitch

If your family is affected by the family glitch, there are a few options you can consider:

Enroll in your employer’s insurance plan: If your employer offers affordable employee-only coverage, you can enroll in that plan and receive the subsidy for your family. However, this may not be the best option if the family plan is not affordable.
Purchase a plan through the Marketplace: You can purchase a health insurance plan through the Health Insurance Marketplace, even if you have access to employer-sponsored insurance. However, you will not be eligible for subsidies if the employer-sponsored insurance is affordable.
Seek professional assistance: You can contact a licensed insurance agent or broker to discuss your options and find the best plan for your family. They can help you determine if you are eligible for subsidies and explore alternative coverage options.

Conclusion

The family glitch is a complex issue that can have a significant financial impact on families. It is important to understand the eligibility requirements for ACA subsidies and to explore all of your options if you are affected by the family glitch. By working with a licensed insurance agent or broker, you can find the best health insurance plan for your family’s needs and financial situation.