KFF April 7, 2021
Cynthia Cox, Krutika Amin, Gary Claxton, Daniel McDermott

Financial assistance to buy health insurance on the Affordable Care Act (ACA) Marketplaces is primarily available for people who cannot get coverage through a public program or their employer. Some exceptions are made, however, including for people whose employer coverage offer is deemed unaffordable or of insufficient value. For example, people can qualify for ACA Marketplace subsidies if their employer requires them to spend more than 9.83% of his household income on the company’s health plan premium.

Currently, this affordability threshold of household income is based on the cost of the employee’s self-only coverage, not the premium required to cover any dependents. In other words, an employee whose contribution for self-only coverage is less than 9.83% of household income is...

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Topics: ACA (Affordable Care Act), CMS, Employer, Govt Agencies, Insurance, Patient / Consumer, Payer
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