On April 6, the Biden Administration released a proposed rule to fix the family glitch. Back in 2021, the President issued an Executive Order asking federal agencies to strengthen the Affordable Care Act. This proposed rule is being used to revise the definition of “affordability” of employer-sponsored coverage as it applies specifically to family members of the employee.
The earliest this proposed rule, if approved, would become effective is January 1, 2023. There is a comment period for stakeholders and there remain some tenuous obstacles that could delay the process.
Current regulations define “affordability” as it pertains to employer-based health insurance as coverage solely for the employee, not for family members, thereby making family members ineligible for a premium tax credit. The proposed changes would allow for the family members of workers, who are offered affordable self-only coverage but unaffordable family coverage, to qualify for premium tax credits in the exchange. While this proposal may help to assist family members with the ability to obtain a subsidy, it would not allow the employee to access a premium tax credit if the employee’s offer of coverage from the employer is deemed affordable. More to come on this topic soon!