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I have received so much help from the Daily Kos group for answering my ACA questions, that I have come to you again for help.  I have a family of four, gross income of less than $30,000/year.  There are (2) adults, (1) young adult at 22 years of age, and (1) child at 2 years old.  The husband has employer provided health insurance, which, to cover just himself, is less than 9.5% of his salary.  However, to cover his complete family, which of course he needs to do, the cost is astronomical; about 30%.  

It would seem to me that the 9.5% of a person's income would pertain to the family cost for insurance, if you are planning on covering your family and you are the sole supporter, right?  In other words, my friend's family should be eligible for insurance through the exchange.  But, I believe I have read that the 9.5% of income is for self insurance only. Is this correct?  If so, how could a family of four



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Comment Preferences

  •  apparently its a problem with the law (0+ / 0-)

    Obama 2012...going to win it with our support!!!

    by mattinjersey on Thu Jan 16, 2014 at 08:39:02 AM PST

  •  Exchange premiums are HIGHER in GOP states (0+ / 0-)

    that refused to develop and maintain their own Exchanges and refused to expand Medicaid.

    "Tax cuts for the 1% create jobs." -- Republicans, HAHAHA - in China

    by MartyM on Thu Jan 16, 2014 at 08:39:33 AM PST

  •  Repubs won't allow technical correction bill (0+ / 0-)

    It is common for any piece of legislation, especially a large complex bill, to have a technical correction bill that fixes what was missed in the original bill.  The Republicans won't allow that for the PPACA.

    Can that couple get a legal separation--on paper only--and the wife & kids get subsidized insurance?  Or a divorce--on paper only?

  •  Yes it is a problem (0+ / 0-)

    Anyone can shop on the exchange, and it is definitely worth it for them to see what the prices would be to insure all or part of the family that way versus the employer. But they won't be eligible for subsidies if the husband has "affordable" insurance.

  •  Unfortunately you are not eligible for subsidies (0+ / 0-)

    The law says that if an employee has insurance coverage through his employer that costs less than 9.5% of family income just to cover him, then the whole family is not eligible for subsidies.

    Even though insurance to cover the entire family is not affordable, you are not eligible for subsidies.

    This seems to be an error in the law's drafting, and should be fixed. But it won't be with the House under Republican control.

  •  Couple of suggestions (0+ / 0-)

    Talk to a navigator person, and play with various options for insuring each person, not as a family unit. Check to see if the 22 year old can get coverage as an independent person, using just his/her income -- likely Medicaid or highly subsidized. I don't think they count parent's income in that case. And check to see if the little one is eligible for S-CHIP. Then you'd only have to buy an exchange policy (or married-couple employer policy) for the second adult.

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