Biden's ACA "Family Glitch" Fix

This article delves into the solution for the "family glitch" issue in the Affordable Care Act (ACA). It explains how the fix impacts family coverage and provides insights on navigating health insurance under these new provisions.

Here are some key points about Biden's plan to fix the "family glitch" in the Affordable Care Act (ACA):

  • The "family glitch" is a quirk in the ACA that prevents some families from getting subsidized health insurance through the ACA marketplaces. It affects families where one spouse has an offer of "affordable" individual employer coverage, even if family coverage is very expensive.
  • Biden has proposed a rule change to fix this glitch by looking at the affordability of family coverage rather than individual coverage when determining subsidy eligibility.
  • The proposed rule change could extend subsidies to up to 5 million currently uninsured Americans, gaining them access to cheaper health plans through the ACA marketplaces.
  • The rule change could take effect as early as 2023, pending final approval. The Biden administration estimates it would cost about $14 billion over 10 years to implement.
  • Republicans and some business groups have criticized the move, arguing it will increase costs for employers and raise premiums. But supporters say it's a necessary fix that will make insurance more accessible and affordable for middle-class families.
  • This rule change is part of Biden's broader efforts to expand access, lower costs, and strengthen the ACA through administrative actions. Other efforts include increasing marketplace subsidies, fixing the Medicaid coverage gap, and strengthening protections for pre-existing conditions.

In summary, Biden's proposed fix aims to close a loophole and extend ACA affordability assistance to millions more families, though it faces some opposition from critics concerned about costs. The final rule is still pending but could take effect next year if approved.

Exploring the remedy for the Affordable Care Act's "family glitch.".

The Affordable Care Act's (ACA) family glitch is a policy that prevents millions of families from accessing affordable health insurance through the ACA marketplaces. The glitch occurs when an employee's employer-sponsored health insurance is affordable for the employee only, but not for the employee's family. In this case, the family is not eligible for premium subsidies in the ACA marketplaces, even though they may be low-income and unable to afford employer-sponsored coverage.

The Biden administration has taken steps to address the family glitch. In January 2022, the administration issued a proposed rule that would make it easier for families to qualify for premium subsidies in the ACA marketplaces. The final rule was published in February 2023 and took effect on January 1, 2023.

Under the new rule, families affected by the family glitch can qualify for premium subsidies in the ACA marketplaces if the cost of employer-sponsored family coverage is more than 9.12% of their household income. This is the same affordability threshold that applies to individuals who do not have access to employer-sponsored health insurance.

To qualify for premium subsidies under the new rule, families must enroll in ACA marketplace coverage during the open enrollment period or through a special enrollment period. Families who are currently enrolled in ACA marketplace coverage may need to update their applications to reflect the new affordability threshold.

The Biden administration estimates that the family glitch fix will make affordable health insurance available to an additional 5 million Americans. The fix is expected to have a particularly positive impact on low-income families and families with children.

Here are some of the benefits of the family glitch fix:

  • It makes affordable health insurance available to millions of Americans who were previously ineligible.
  • It helps to reduce the number of uninsured Americans.
  • It helps to make health insurance more affordable for families.
  • It helps to improve access to quality health care for families.

The family glitch fix is a significant step forward in making health insurance more affordable and accessible for all Americans.