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New ACA Rule Makes More Dependents Eligible

ACA
Page with ACA (Affordable Care Act) on the table with a stethoscope, medical concept. | Image by WIN12_ET, Shutterstock

Healthcare applications through HealthCare.Gov Marketplace will experience some changes this year. These health plans were started by the Affordable Care Act (ACA).

In previous years, the government would calculate whether or not an individual’s employer’s insurance was deemed “affordable” to determine if someone was eligible to sign up under the ACA.

The government only considered whether the plan was affordable for the employee, not for his entire family.

The Biden administration is addressing the issue with a new rule this year.

The new calculation considers whether an employer’s plan is affordable for the employee and his dependents. If the coverage offered by the person’s employer is not considered affordable for his dependents, they may now be newly eligible for ACA coverage.

An analysis conducted last year estimated that over 670,000 dependents fell into this category of not being eligible for insurance through ACA due to an employer’s plan being “unaffordable.”

Individuals can check on the HealthCare.Gov website to see if they might save on Marketplace premiums, or qualify for Medicaid or Children’s Health Insurance Program (CHIP), based on their income.Individuals can calculate their potential monthly subsidy for coverage here, using Kaiser’s “Health Insurance Marketplace Calculator.”

For those uninsured, open enrollment for coverage under the ACA begins November 1, 2022 and runs through January 15, 2023. In order to have coverage that will begin on January 1, individuals need to enroll by December 15.

Any enrollments after December 15 will go into effect on February 1, 2023. The date of coverage is also dependent on applicants paying their first premium on time.According to WFAA, the average monthly ACA premium in Texas is $86 per month, but the Biden administration claims that four out of five people can find medical coverage for less than $10 dollars per month.

Texas residents are the most uninsured of any state, with 5,224,044 Texans without coverage when last counted. After the last enrollment period, Texas set a new record for the number of ACA signups, with 1,840,947 people getting coverage, a 42% increase from the prior year.

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1 Comment

  1. Marianne

    I have signed on already with about 20.000 a year I will be paying 185.99 a month and that is a third of my 2 week pay check. I don’t get it. Aca is expensive for me but have to have insurance because of health issues

    Reply

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