David

ACA affordability exemption

3 posts in this topic

Parents don't have health insurance coverage but the 4 kids are covered by a government program.

I am trying to determine if the TPs qualify for the affordability exemption. The instructions aren't clear (at least to me) whether the household size includes the kids or not since they are covered by a government health insurance program.

The TPs AGI is $88K. If the household size is 6 for the affordability exemption calculation then the income is 275% above the poverty level. If the calculation should be based on a household size of 2 since the kids are already covered, then the income is well above the poverty level.

It seems as though the affordabiltty calculation should be based on the household size of the number of people not covered when all other family members are covered by a government program. However, I don't see any clear instructions regarding this in any of the ACA material.

Can anyone clarify this for me?

Thanks.

 

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It is my understanding that if they can claim the children as dependents, they count for the purpose of determining affordability.  Even though they may not pay for their insurance, they are paying all of the other bills (one assumes) and providing more than 50% of support since they are claiming the exemption.  Therefore, they count for purposes of calculating income in relation to the poverty level.

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Thanks.

Is the lowest bronze plan premium for each child also considered in the calculation? I would think so even if they are covered by a government plan since they are counted in the household size.

The links for the lowest bronze plan premium point to Colorado Health Connect. When I go to their site, the web page no longer exists. I found another site that gave the bronze plan premium for Colorado but it only asked the age of the head of the household and gave a $249 per month premium. It didn't ask how many family members. Is it reasonable that that would be the monthly premium for a family of 6?

Thanks for your help.

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