Understanding the ACA Income Threshold: What Happens If You Fall Below It?

The Affordable Care Act (ACA) has been a topic of much discussion and debate, and it’s important to understand how it works in order to make informed decisions about your health insurance coverage. One of the key provisions of the ACA is the income threshold for receiving subsidies for health insurance. This blog post will delve into what happens if you end up below the income threshold for ACA coverage.

What is the ACA Income Threshold?

The ACA income threshold is the minimum income level that you must earn in order to qualify for subsidies for health insurance. The threshold varies by state, and it’s based on the federal poverty level (FPL). For 2023, the federal poverty level is $13,590 for an individual and $27,750 for a family of four.

What Happens If You Fall Below the ACA Income Threshold?

If you end up earning below the ACA income threshold, there are a few things that can happen:

You may not be eligible for subsidies. This means that you will have to pay the full cost of your health insurance premiums.
You may be eligible for Medicaid. Medicaid is a government health insurance program for low-income individuals and families. If you qualify for Medicaid, you will not have to pay any premiums or deductibles.
You may have to repay some or all of the subsidies you received. If you received subsidies for health insurance and you end up earning below the income threshold, you may have to repay some or all of the subsidies.

How to Avoid Repaying ACA Subsidies

There are a few things you can do to avoid repaying ACA subsidies:

Make sure you estimate your income accurately when you apply for health insurance. The ACA income threshold is based on your expected income for the year. If you underestimate your income, you may end up receiving subsidies that you are not eligible for.
Update your income estimate if your income changes. If your income changes during the year, you should update your income estimate on HealthCare.gov. This will help to ensure that you are receiving the correct amount of subsidies.
If you end up earning below the ACA income threshold, you can contact the Marketplace to report your income change. The Marketplace will then determine if you are eligible for Medicaid or if you have to repay any subsidies.

Don’t Be Afraid to Seek Professional Help

If you have any questions about the ACA income threshold or how it affects your health insurance coverage, don’t be afraid to reach out to a licensed insurance agent about your ACA healthcare insurance. They can help you understand your options and make sure that you are getting the coverage you need.