A new IRS rule that goes into effect for coverage beginning January 1, 2023, addresses the family glitch that kept some families from obtaining premium tax credits in the ACA Individual Marketplace. This new rule can benefit anyone looking for family coverage in the Marketplace, including those who may no longer qualify for an employer- or government-sponsored plan.
Under prior rules, employees and their dependents were not eligible for subsidies if the cost of the employee’s self-only plan was under the household income limit, with no consideration of the cost for family coverage.
Under the new rule, family coverage is deemed affordable if the employee’s cost for family coverage under the employer plan is below the income limit.
The change was proposed to address the roughly 5 million people who are affected by the glitch. Federal government projections suggest that roughly 1 million people will take advantage of the rule to obtain lower premiums through subsidies.
2023 subsidy calculators are expected to be updated with new limits in November 2022.
This change may provide new coverage choices for some of your clients. You can help them learn if they now qualify for subsidies for health coverage.