Your Source for Health Reform

Topic: Financial Assistance



Financial assistance is available to lower- and middle-income people buying plans on the Marketplace in the form of tax credits and cost-sharing reductions. People with income up to four times the federal poverty level can pay reduced premiums, and those with income below 250% can have lower out-of-pocket costs, such as deductibles and copays. About 80% of people enrolling in first round qualified for assistance.


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ACA Guides for Farmworker Families

These fact sheets from Farmworker Justice provide basic information on health insurance options for farmworkers and their family members who may be eligible for tax credits, as well as providing information about the health insurance requirement (the “minimum essential coverage” provision). The fact sheets are available in English and Spanish. (more…)

Defining Households for Medicaid and Premium Tax Credits

This August 2013 presentation from the Center on Budget and Policy Priorities explains why household size and composition matter in determining eligibility for Medicaid and for subsidies under the ACA. The rules for how this is done are illustrated with some simple examples.

Illinois Uninsured Profile under ACA

This January 2014 fact sheet from the 2014 Kaiser Family Foundation shows that about two-thirds of uninsured nonelderly people in the state are eligible for financial assistance through either Medicaid or the Marketplace.

HHS Notice of Benefit and Payment Parameters for 2015

This HHS rule, issued in March 2014, addresses a number of Marketplace and private insurance issues related to federally-run insurance exchanges, financial assistance, and the operation of the SHOP for small businesses. (more…)

State Health Reform Assistance Network Charting the Road to Coverage

The purpose of this presentation is to provide detailed information on Advance Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs). Both programs are critical to the effort to ensure that Marketplaces can offer affordable coverage. This issue brief is courtesy of Manatt Health Solutions and the Robert Wood Johnson Foundation.

ACA Tax Provisions

This mini-site from the IRS addresses how the Affordable Care Act tax provisions will affect individuals and families, employers, and organizations. The law’s tax-related provisions include financial assistance options for individuals and families, including the premium tax credit, the individual shared responsibility provision and exemptions from that provision, as well as provisions for employer and others. The IRS administers the tax provisions included in the law.

Cost-Sharing Reductions: Beyond the Basics

This June 19th, 2013 powerpoint covers a variety of topics, including cost-sharing in the marketplace (exchange) plans, how cost-sharing reductions work, and plan options for consumers.

Premium Tax Credits: Beyond the Basics

This June 5th, 2013 powerpoint covers a variety of topics, including premium credit basics, determining the amount of the premium credit, factors that affect the amount of credit, how to get the premium credits, and the impact of changes in income throughout the year.

Health Reform Beyond the Basics: Premium Tax Credits

This May 2013 fact sheet by the Center on Budget and Policy Priorities answers some frequently asked questions about Premium Tax Credits.

How the Affordable Care Act Makes Health Coverage More Affordable

This May 2013 fact sheet from Families USA summarizes the consumer protections and financial assistance to help people purchase coverage. (more…)

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