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Affordable Care Act (ACA) “Family Glitch”

famili-glitch

The “Family Glitch” is a hole in the Affordable Care Act that affects low to moderate income families to not qualify for premium assistance on the health exchange. This is due to the rules that determine the “affordability” of employer offered health insurance.

The aim of the ACA was to provide affordable healthcare to all, so access to affordable health insurance at work would disqualify you from getting it through the Marketplace. For families the problem lies in the definition of “affordable.” It is based on the cost of insurance to cover just the individual (employee) and doesn’t take into consideration the much higher cost of covering the family. Unfortunately, it will take time for legislation to fix this obvious glitch.

In the meantime, if this is your situation, here are a few things to know:

  • If your plan at work costs 8% or more of your household income it may give you an exemption to avoid the tax penalty if you go without insurance.
  • Those under 30 years old may purchase a catastrophic plan with a high deductible.
  • Children under 19 may qualify for Medi-Cal or CCHIP (County Child Health Insurance Program), if the household income falls within a certain range. These are government health programs that could help keep the cost of covering your family lower. Give your county human services agency a call to help you determine eligibility.
  • Consider purchasing a full priced individual/family plan for your spouse and or/children. We suggest you shop around to compare plan premiums and benefits. Contact us, and we can help you get a quote and compare plans.