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Biden to Expand Health Insurance Subsidy, Solve ‘Family Glitch’

April 5, 2022, 9:00 AM

The Biden administration plans to adjust how the Treasury Department determines who is eligible for a health insurance subsidy through the Affordable Care Act, addressing a longtime issue for millions of families.

This problem, known as the “family glitch,” happens when a worker has employer-based coverage that is deemed “affordable” by the Treasury Department where they pay less than 9.83% of household income. However, that determination doesn’t take into consideration if the cost would increase beyond that by adding family members to the plan. This leads to some families who would have to pay more than what is deemed affordable, but who are unable to be eligible for Affordable Care Act-based subsidies.

The Treasury Department will put out a proposed rule (RIN 545-BQ16) Tuesday that determines affordability of coverage for the entire family—not just the sole worker, a senior administration official told reporters.

The Biden administration estimates 200,000 uninsured people would gain coverage and about 1 million more would see lower premiums under this regulation, the official said.

President Joe Biden will officially announce the regulation and a related executive order Tuesday at an event with former President Barack Obama.

Biden and Obama “both see the Affordable Care Act is an example, a shining example, of how government can work for the American people. Not only did it ensure that millions of people had access to affordable health care, but it has been an opportunity to build on that and make changes and make improvements over the course of time,” White House Press Secretary Jen Psaki said Monday.

The executive order will direct agencies to “continue their efforts to strengthen access to affordable, high-quality health care,” the official said, including a focus on enrollment, improving benefits and access to doctors and nurses, expanding eligibility, and reducing the burden of medical debt.

The administration doesn’t plan to release estimates of how many people in total are affected by the family glitch, the official said. The Kaiser Family Foundation estimatesthat number to be 5.1 million.

The rule would take effect Jan. 1, 2023, allowing people to receive financial assistance during the next open enrollment period in November, the official said.

—With assistance from Josh Wingrove

To contact the reporter on this story: Shira Stein in Washington at sstein@bloomberglaw.com

To contact the editor responsible for this story: Brent Bierman at bbierman@bloomberglaw.com