Millions More Americans May Be Eligible for ACA Tax Credits

Data released by HHS today revealed that up to 2.5 million Americans who currently buy health coverage outside the Marketplace could qualify for tax credit assistance under the Affordable Care Act (ACA), if they switch to a Marketplace plan for 2017.

Six states (California, Texas, Florida, North Carolina, Illinois, and Pennsylvania) each have over 100,000 residents eligible for the tax credits. Over 9 million individuals currently enrolled in a Marketplace plan receive financial assistance, but HHS Secretary Sylvia M. Burwell said “today’s data show millions more Americans could benefit.”

Right now, an estimated 6.9 million people are purchasing individual coverage through off-Marketplace plans, which means they cannot receive the tax credits designed to keep premiums affordable. These credits are available to consumers enrolled in the Marketplace with incomes between 100% and 400% of the federal poverty level.

The HHS data indicated that more than 70% of individuals currently enrolled in either Marketplace or off-Marketplace plans would be eligible for the tax credits based on their income. This figure jumps to 80% when including the uninsured who are eligible for Marketplace coverage. Around 9 million of the 10.7 million Marketplace-eligible uninsured Americans could receive the tax credit assistance based on their income level.

The report suggested that lack of awareness of the potential savings could be the main factor for these missed opportunities for savings. A recent study found that only 52% of uninsured adults knew that the Marketplace has financial assistance available.

Young Americans in particular are less likely to take advantage of the potential tax credits even though many of them are eligible. “More than 9 in 10 Marketplace-eligible young adults without health insurance have incomes that could qualify them for tax credits to make plans affordable, but that fact hasn’t fully penetrated the millennial community, and we want to change that,” said Kevin Counihan, HealthCare.gov CEO, during last week’s Millennial Outreach and Engagement Summit.

In response to these findings, HHS plans to increase outreach to Marketplace-eligible Americans of all ages who are unaware of how they could save money by enrolling in a Marketplace plan. These initiatives included the use of marketing to target the uninsured and making it easier for agents and brokers to enroll off-Marketplace consumers.