WPS Health Insurance

ACA Subsidies Will Help Struggling Americans Afford Health Insurance

Beginning in 2014, if you are a single person making less than $44,680 annually (in 2012 dollars) or have a family of four that makes less than $92,200 per year (in 2012 dollars), and your employer doesn't offer affordable coverage, you may be able to get some help paying for your health insurance premium.1

The Affordable Care Act (ACA) will make tax credits from the federal government available for people whose income is between 100 and 400% of the federal poverty level who are not eligible for other affordable coverage (through an employer, for example). The credits are tied to insurance plans at the "silver" level in the area where a person lives. For insurance at a higher level, the insured will have to pay the additional cost. People whose incomes are up to 250% of the poverty level may also be eligible for reduced cost sharing for copays, coinsurance, and other costs.2

The tax credit is "advanceable," which means that instead of waiting for tax time to get your money in a lump sum, it is "advanced" to you so you can lower your insurance premium each month. You don't have to pay and then wait to be reimbursed. The tax credit is available as soon as you enroll in a plan. It's paid directly to your insurance company to offset your premium.

The tax credit, unlike a tax deduction, reduces the amount of tax you owe dollar for dollar. Those who qualify for tax credits may also qualify for reduced cost sharing for their insurance, such as copayments, coinsurance, and deductibles.

People earning 133% of the poverty level or less are not eligible for these tax credits, but are instead eligible for Medicaid. Low-income children are eligible for the Children's Health Insurance Program (CHIP).

Tax Credits
Estimates are 2014 projected costs based on a 30-year-old person in a medium-cost region.
Percent of federal poverty level Income range
(in 2014 dollars)		 Health insurance premium
(adjusted for age)		 Maximum % of income for the premium Actual required premium payment Government tax credit
Single person
134-150% $15,417–$17,258 $3,440 3.06–4.00% $472–$690 $2,969–$2,750
151-200% $17,373–$23,011 $3,440 4.05–6.30% $703–$1,450 $2,737–$1,991
201-250% $23,136–$27,925 $3,440 6.33–8.05% $1,465–$2,315 $1,975–$1,125
251-300% $28,878–$33,510 $3,440 8.08-9.50% $2,333–$3,279 $1,107–$161
301-400% $34,631–$46,021 $3,440 9.50% $3,290–$3,440 $150–$0
Family of 4
134-150% $31,389–$35,137 $10,108 3.06–4.00% $960–$1,405 $9,148–$8,703
151-200% $35,372–$46,850 $10,108 4.05–6.30% $1,431–$2,952 $8,677–$7,157
201-250% $47,084–$58,562 $10,108 6.33–8.05% $2,983–$4,714 $7,126–$5,394
251-300% $258,797–$70,275 $10,108 8.08-9.50% $4,750–$6,676 $5,358–$3,432
301-400% $70,509–$93,700 $10,108 9.50% $6,698–$8,901 $3,140–$1,207

If your employer does not offer coverage, or if it's too expensive, you can find consumer help online.

1 Kaiser Family Foundation. Health Reform Subsidy Calculator.
Retrieved from http://healthreform.kff.org/SubsidyCalculator.aspx

2 Kaiser Family Foundation. Focus on Health Reform: Explaining Health Care Reform: Questions About Health Insurance Subsidies (July 2012).
Retrieved from http://www.kff.org/healthreform/upload/7962-02.pdf

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