There's finally been a fix to the 'family glitch' that made marketplace health plans sometimes unaffordable. And although premiums are rising, subsidies are too, and more people are eligible.
Thanks to the change in the rules, two calculations now will occur: the cost of the employee-only coverage as a percentage of the worker's income and the cost of adding family members. In some cases, the worker may decide to remain on the employer plan because his or her payment toward coverage falls below the affordability threshold, but the family members will be able to get a subsidized ACA plan.
Previous legislative efforts to resolve the family glitch failed, and the Biden administration's use of regulation to fix it is controversial. The move might ultimately be challenged in court. Still, the rules are in place for 2023, and experts, including Corlette, say families who could benefit should go ahead and enroll.
"It will take a while for all that to get resolved," she says, adding that it unlikely that there would be any decision in time to affect policies for 2023.published last year estimated that the net savings per family from this change in regulations might be about $400 per person, and the cost to the federal government for new subsidies could be $2.6 billion a year.
Ultimately, that might mean patients will have to start paying a share of the cost of cancer screenings or pay part of the cost of drugs that prevent the transmission of HIV. The judge has yet to rule on how many people the case will affect. But, for now, the ruling applies only to the employers and individuals who brought the lawsuit. So, your no-cost screening mammogram or colonoscopy is still no-cost.
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