FOR IMMEDIATE RELEASE
April 5, 2022
CONTACT: Jack Cardinal, (781) 960-5208
(BOSTON, MA) – Today, the Biden administration announced a proposed rule to fix the “family glitch” within the Affordable Care Act. The elimination of the “family glitch” would open the door to more affordable coverage for five million people, more than half of whom are children. The “family glitch” has impacted families across the country for more than a decade – putting affordable coverage out of reach. People impacted by the family glitch are primarily low-income children and women who will finally have the option for more affordable coverage under the ACA Marketplaces.
Statement of Community Catalyst Executive Director Emily Stewart in response to the Biden administration’s proposed rule on the “family glitch”:
“Today’s proposed rule to fix the family glitch represents a big step forward for families who need more affordable health coverage. We applaud today’s action from the Biden administration and will do everything we can to get this proposed rule over the finish line as soon as possible. For more than a decade, health advocates have been calling for today’s change, and we are thrilled the Biden administration is taking this step for 5 million people. Fixing the family glitch is especially important for children, who make up more than half of those impacted and are at risk of missing well visits, vaccinations and other important care as a result.”
THE FAMILY GLITCH
Under current Affordable Care Act rules, millions of people are shut out of ACA Marketplace premium and cost-sharing benefits because of a misinterpretation of statute that excludes families from an affordability test, which leads to ineligibility for financial assistance for many low-to-moderate-income families.
Specifically, the current rule only counted the cost of an employee’s “self-only” coverage (versus the cost of family coverage) in determining whether or not their employer offers affordable coverage.
Under the ACA, if an employee’s share of employer-based insurance exceeds 9.83 percent, then they qualify for premium assistance and cost-sharing support. Since ACA regulations limited that affordability calculation to “self-only” coverage, millions of people were unable to access more affordable coverage for their dependents on the ACA’s Marketplaces. This harmful misinterpretation is known as the “family glitch.”
WHAT THIS MEANS
An estimated 5.1 million people will have access to more affordable coverage options if this proposed rule is finalized.
Families switching from unaffordable employer coverage could save on average $400 per person in premiums.
Over half of the population impacted by the family glitch are children of low-wage workers, which means finalizing this rule will result in better access to well child visits, specialty care and vaccinations, improving social, emotional and developmental outcomes.
Fixing the family glitch will fill an important gap in coverage and affordability polices in furtherance of the overarching goals of the Affordable Care Act.
About Community Catalyst: Community Catalyst is a leading non-profit national health advocacy organization dedicated to advancing a movement for health equity and justice. We partner with local, state and national advocates to leverage and build power so all people can influence decisions that affect their health. Health systems will not be accountable to people without a fully engaged and organized community voice. That’s why we work every day to ensure people’s interests are represented wherever important decisions about health and health care are made: in communities, state houses and on Capitol Hill. For more information, visit http://www.communitycatalyst.org. Follow us on Twitter @CommCatHealth.