BEYOND THE NUMBERS
About 2.5 million people who aren’t buying health coverage on health reform’s insurance marketplaces could get help paying for their coverage if they did so, according to new research from the Department of Health and Human Services (HHS) — including 313,000 people in California, 252,000 in Texas, and over 100,000 each in Florida, Illinois, North Carolina, and Pennsylvania.
People with incomes below 400 percent of the poverty line — about $100,000 a year for a family of four — who buy coverage on the marketplaces may qualify for tax credits to help them pay their premiums. Those with incomes below 250 percent of the poverty line can qualify for additional help that reduces their deductibles and other cost-sharing charges. About 1.1 million of the 2.5 million who could get help with premiums would also qualify for help with cost-sharing, HHS estimates.
The marketplaces, which determine whether people qualify for financial assistance, are the only place people can get help paying their premiums. The millions who are missing out on getting subsidies should prepare now to make a change and take advantage of available help. From November 1 through January 31, people can sign up for marketplace coverage and learn whether they qualify for subsidies. Coverage and subsidies take effect on January 1, 2017 for those who sign up by December 15.
In 2016, 85 percent of people who chose plans through the marketplace in the 38 states using HealthCare.gov were eligible for premium tax credits. Those tax credits covered 73 percent of the total premiums for those who qualified, according to earlier HHS research. This help is too valuable for low- and moderate-income families to forgo.