The Affordable Care Act (ACA), also known as Obamacare, was enacted to make health insurance more affordable and accessible for Americans. One of the key provisions of the ACA is the Advanced Premium Tax Credit (APTC) subsidy, which helps individuals and families pay for health insurance premiums in the ACA Marketplace.
The APTC subsidy is available to individuals and families who purchase health insurance through the ACA Marketplace and meet certain income requirements. The amount of the subsidy is based on a person’s income, household size, and the cost of health insurance premiums in their area.
In addition to the APTC subsidy, there are also Cost-Sharing Reduction (CSR) subsidies available for those who choose a Silver-level plan. CSR subsidies are designed to reduce out-of-pocket costs for individuals and families who have incomes between 100% and 250% of the Federal Poverty Level (FPL). Under the CSR program, individuals and families who choose a Silver-level plan will have lower deductibles, copayments, and coinsurance than those who choose a Bronze, Gold, or Platinum plan.
Starting in 2023, there will also be a Special Enrollment Period (SEP) available for individuals and families with incomes under 150% of the FPL. This SEP will allow them to enroll in a CSR-level Silver plan outside of the regular open enrollment period. The SEP will be available year-round, which means that individuals and families who qualify can enroll in a CSR-level Silver plan at any time during the year.
It’s important to note that the APTC and CSR subsidies are only available to individuals and families who purchase health insurance through the ACA Marketplace. Those who purchase health insurance outside of the Marketplace will not be eligible for these subsidies.
In conclusion, the APTC subsidy is a key provision of the ACA that helps make health insurance more affordable for individuals and families. The addition of CSR subsidies for Silver-level plans and the new SEP for incomes under 150% of the FPL in 2023 will further help reduce out-of-pocket costs for those who need it the most. If you’re considering purchasing health insurance through the ACA Marketplace, be sure to explore all of the available subsidies and options to find the plan that best fits your needs and budget.
APTC tax credit subsidies are available for almost all eligible tax filers, thanks to the American Rescue Plan Act (ARPA) in 2021-2022. Premium contribution is now capped at 8.5% of Modified AGI for those with higher incomes. Premiums for plans are determined by family members & ages, so the “maximum income” limit is different for each scenario.
** This chart is only accurate for those in Federal Health Insurance Marketplace (healthcare.gov) states which have NOT expanded Medicaid. We here at Hummingbird disagree with this decision over the last several years of our state lawmakers as a whole: we have personally watched our local citizens in the South suffer health-wise and financially, our hospital systems suffer financially, and our society suffer as a result of these decisions by politicians, not by the people =(
