Kevin Knauss: Health, History, Travel, Insurance
Posts related to the ACA Premium Tax Credit issued by Covered California.
Lines 24 through 26 of Part II of form 8962 determine if the household is eligible for an additional Premium Tax Credit. In this situation, the final household MAGI was slightly lower than estimated income amount of the Covered California application. The result is that the household is eligible for an additional $23 in Premium Tax Credit. They were eligible for an annual subsidy of $16,832, but only received $16,809.
Column A. Monthly enrollment premiums is the full premium rate for the health insurance that the family members were enrolled in for the month. The important role this dollar amount plays is limiting your health insurance Premium Tax Credit subsidy. You can only receive a subsidy equal to the cost of the health insurance. If you are eligible for a subsidy of $2,500 per month, but enroll in a health plan that only costs $2,000 per month, your subsidy will be limited to $2,000.
Of course, if the annual premium for the second lowest cost Silver plan increases more than the other plans, it increases the subsidy for all consumers. In this example, the consumer would see monthly premiums for most plans below the 2022 levels. However, the second lowest cost Silver plan would have no increase from 2022 to 2023, even with the larger annual unsubsidized premium increase.
From my perspective, universal basic monthly income is already happening. Covered California gets money from the federal government and then sends it to the health plans. Whether the average amount is $424 or the real-world case of $2,094 per month, the Covered California subsidy is a real dollar amount that helps thousands of families in California. Perhaps Yang and Harris should study how the ACA and Covered California work and not tout their proposals has new or groundbreaking. The federal government is already paying out money on behalf of millions of health insurance consumers to make the monthly premiums affordable, which frees up money to pay all the other bills.
Covered California consumers are penalized for having the good fortune of their household income’s increase. To add another layer of insult, if the consumer makes over 400% of the federal poverty level, they have to repay all the monthly tax credit subsidies they received during the year and pay for an artificially inflated Silver plan rate. Ouch!
In order determine how my clients might be affected by the proposed new Premium Tax Credits under the American Heath Care Act (AHCA or Trumpcare) introduced by the Republicans in March 2017, I compared the current income based Premium Tax Credits under the ACA to the new age based tax credits of the AHCA. On average, my clients included in the comparison will lose $157 per month to help pay for their health insurance. Young individuals, under 30 years old, have the smallest change of premium tax credit under the age based rules. Within my clients, people over 55 year old will get hit the hardest losing $200 to $400 per month in premium tax credit assistance.
Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
The formula for determining how much premium assistance, also known as the Affordable Care Act premium tax credits (PTC), to lower your monthly health bill is complicated. At its core the formula uses the inputs of your age, MAGI, a special contribution percentage and the annual cost of the Second Lowest Cost Silver Plan. Plugged into the formula, these inputs determine if any Advance Premium Tax Credits (APTC) will be awarded to reduce your health insurance premium. Some people are surprised to learn they don’t qualify for any APTC even though their MAGI is below 400% of the federal poverty level.
Covered California is cancelling the Advance Premium Tax Credit subsidy that lowers a household’s monthly health insurance premium for 2016 for some consumers. Through Covered California’s automatic renewal process I’ve seen several families’ tax credits disappear for 2016. Without intervention or explanation, many families who had their health insurance automatically renewed may receive a bill for the full premium amount because the tax credit subsidy was eliminated by Covered California.
One of the most frustrating aspects of the Affordable Care Act is that it excludes family members from receiving the premium tax credits to reduce their health insurance if one of the parents is offered affordable employer group health insurance. One way around this problem is for the employer to offer employee only coverage. Covered California for Small Business health insurance exchange offers the employee only option for employers when they set up their group health plans.
