USA – Changing the “Family Glitch” Would Make Health Coverage More Affordable for Many Families (Urban Institute)

Under the Affordable Care Act (ACA), families are generally ineligible for Marketplace premium tax credits (PTCs) if a family member is offered worker-only coverage through an employer that is deemed affordable. The cost of covering the entire family, however, is not considered and may be unaffordable. Coverage is considered affordable if employee contributions for worker-only coverage do not exceed 9.83 percent of family income. In this brief, we investigate the impact of a proposed change that some legal experts believe the US Treasury Department and Internal Revenue Service could make through administrative action or that could be made through legislation: If family coverage is unaffordable, all family members except workers with affordable offers of single coverage would be eligible for Marketplace PTCs.