Christine Jordan Sexton
Members of President Joe Biden’s administration announced Tuesday they is proposing a rule to fix the so-called “family glitch” in the Affordable Care Act (ACA) that adversely impacts about 5 million people nationwide and as many as 269,000 people in Florida, according to a 2019 study.
The Treasury Department and the Internal Revenue Service are proposing new regulations that end the issue, which arises when an employer offers an employee access to affordable individual health insurance coverage, but not access to affordable family coverage.
Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit that can be used to buy a policy on the federal health care marketplace or exchange. There is no affordability requirement though when it comes to affordability for employer-sponsored family coverage, which can be expensive. The current regulations don’t allow an employee’s family to qualify for tax credits to offset the costs of policies sold on the federal exchange.
The Biden administration maintains that if the rule is changed to accommodate families, an estimated 200,000 uninsured people would gain health insurance coverage, and nearly 1 million Americans would have lower health insurance premiums.
“This proposed rule would amount to the most significant administrative action to improve implementation of the ACA since its enactment,” the administration said in a “fact sheet” that was distributed to the press following the announcement.
Passed in March 2010, the Affordable Care Act is sweeping legislation that changed how health insurance was sold. It required carriers to offer policies to people with prior pre-existing conditions. The law also expanded the groups of people who are eligible for Medicaid.
The law initially mandated that states allow low-income childless adults to enroll in Medicaid and would have punished states that didn’t expand Medicaid under the law by withholding federal funds. But the U.S. Supreme Court struck down that provision of the law, essentially making the Medicaid expansion optional.
Florida is one of 12 states that has not expanded Medicaid to low-income childless adults.
Florida leads the nation when it comes to using the federal health insurance exchange to buy a subsidized health insurance policy. More than 2.7 million enrolled in a health plan using the exchange in 2022.
According to the Kaiser Family Foundation, there were an estimated 269,000 people in Florida in 2019 that were blocked from using the exchange due to the existing rules on employer sponsored family coverage.
Meanwhile, Florida Democratic Party spokesperson Travis Reuther issued a statement Tuesday praising Biden, who made the announcement during a visit to the White House by former President Barack Obama.
“Fixing the family glitch means substantially lowering monthly health care costs for hundreds of thousands of working families in Florida and getting people the financial help they need so they can take their kids to the doctor without breaking the bank. That’s what President Biden and Democrats are focused on and why President Obama is visiting the White House today,” Reuther said in a prepared release.
“Despite this progress, Republicans are still trying to overturn the Affordable Care Act because they care more about helping out big insurance and pharmaceutical companies than they do about helping working families.”
