The disappearance of the ‘family glitch’ could help 40,000 more Kansans afford health insurance | KCUR 89.3

Taxpayer subsidies for health insurance have been available to millions of Americans since the Affordable Care Act took effect during the Obama administration.

But not for everyone.

Some people who earned too much money to qualify for Medicaid—and too little to afford policies from their employers that covered the rest of their families—got caught in what became known as the “family glitch.” “. The government saw the individual employer policies of those workers as affordable, although the cost of covering a spouse and children has been very expensive.

It has changed.

Now those workers can sign up for health insurance in the Affordable Care Act Marketplace and qualify for government subsidies so they can buy coverage for the rest of their family members.

“(The ‘family glitch’) made a lot of people really disappointed,” said Kathy Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation. “They go to the market and see, ‘Wow, that’s like $1,300 a month to cover my family.’ You know I’m so disappointed.

“So,” he said, “many people will find that they are eligible for subsidies and the cost is more reasonable.”

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The ACA Marketplace enrollment period began Tuesday. It runs until January 15. People who want their coverage to begin at the beginning of 2023 need to enroll by December 15.

Experts say the changes that expand who qualifies for subsidies will likely mean more people will be able to buy health coverage.

“A large number of people have not been able to pay the premiums,” in previous years, said Kate Gramlich, project specialist with Cover Kansas. The organization helps people navigate the ACA Marketplace. “So they just went uninsured. And so we’re hoping there’s a big bump in enrollments and in coverage for Kansans with this fixed.”

The update that changes the “family glitch” could make coverage more affordable for about 40,000 more Kansans.

“It’s a huge deal,” Gramlich said.

She said most of the people locked out by the old rules were women and children.

Subsidies and tax credits from the federal pandemic economic stimulus plan and the Inflation Reduction Act enacted earlier this year have largely offset increases in premiums from health insurance companies.

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The Centers for Medicare and Medicaid Services estimates four out of five people on the market qualify for plans that cost them $10 or less per month — after calculating in tax credits.

In Kansas, UnitedHealthcare entered several counties that did not sell coverage last year. That gives people in some parts of the state new options.

All plans offered in Kansas are Exclusive Provider Organizations, meaning closed networks. So Hempstead recommends making sure a preferred doctor or hospital takes insurance from a particular plan before buying a plan.

And he said the process can be confusing. Then ask for help. Trained navigators to help people find the best job plans out of 18 locations in the state. You can find them at getcoveredkansas.org or get online help through this website. Those browsers are paid for by taxpayers, so there is no cost and no sales incentives for them.

“It can be super overwhelming,” he said. “This is a really big decision.”

Hempstead said people who already enroll through the marketplace should not automatically enroll in their existing plan.

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“You can also see that one plan is a better value than another,” he said, “in a new year.”

Last year saw a record number of subscribers and experts expect to see market demand to continue to grow.

University of Kansas economics professor David Slusky said changes in ACA policy will continue to drive more enrollment.

“The whole point of the ACA is to get the millions of Americans who didn’t get health insurance through the previous existing systems, a way to get health insurance affordably,” Slutsky said. “That’s the goal. And we’re slowly clearing it.”

Samantha Horton reports on health for the Kansas News Service. You can follow her on Twitter @SamHorton5.

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and its connection to public policy.

Kansas News Service stories and photos may be republished by media at no charge with proper attribution and a link to ksnewsservice.org.



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