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Wednesday, Oct 12 2022

Full Issue

Rule Fixes ACA's 'Family Glitch,' Making More Eligible For Subsidies

Regulations released by the Treasury Department close a loophole that blocked family members from receiving Affordable Care Act tax credits if someone in their household had access to an economical employer-sponsored health plan. The change covers 2023 enrollments that start Nov. 1.

Nearly 1 million additional Americans will have access to ObamaCare subsidies next year under a final rule issued Tuesday by the Biden administration. The rule fixes the so-called family glitch, a loophole in the health law that prevents family members from receiving ObamaCare subsidies if a household member has access to an affordable employer-sponsored health plan.聽(Weixel, 10/11)

The rule doesn鈥檛 change significantly from the proposal issued in April. The regulation focuses on a provision of the ACA that entitles low-income Americans to get premium assistance on the marketplace if their employer-sponsored insurance doesn鈥檛 reach a certain threshold.聽An employee would qualify for such assistance if they must spend more than 9.5% of their household income on premiums. However, a glitch in the regulation meant that the threshold only affects the individual鈥檚 health plan and not the premium for dependents.聽While the individual and family can meet the 9.5% threshold, they would only get premium assistance for just the individual鈥檚 healthcare costs. (King, 10/11)

The problem was that employer-based health plans have been considered affordable as long as the coverage was within the financial means of an employee, regardless of whether it was too expensive for family members. As a result, the family members were not eligible for the subsidies they may have needed, the White House said. The open enrollment period for health insurance plans under the Affordable Care Act starts on Nov. 1. (Aboulenein, 10/11)

The announcement comes less than a month before the start of open enrollment for 2023 coverage on the Obamacare exchanges. Americans can start signing up on November 1. (Luhby, 10/11)

鈥淭oday鈥檚 action resolves a flaw in prior ACA regulations to bring more affordable coverage to about one million Americans,鈥 Health and Human Services Secretary Xavier Becerra said in a statement. 鈥淥ur goal is simple: leave no one behind, and give everyone the peace of mind that comes with health insurance.鈥 The number of uninsured Americans has dipped to a historic low of 8% this year, with an estimated 26 million people in the U.S. still without health insurance. (10/11)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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