Final Rule Fixing the “Family Glitch” Puts Accessible, Affordable Care in the Reach of Millions

 

FOR IMMEDIATE RELEASE  

Oct.11, 2022    

CONTACT: Jack Cardinal, (781) 960-5208, jcardinal@communitycatalyst.org


(BOSTON, MA) – Today, the IRS announced its final rule fixing the “family glitch,” an erroneous interpretation of the Affordable Care Act which has kept health coverage out of reach for more than five million people – mainly women and children. 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 IRS and Biden administration’s fixing of the “family glitch”:  

“With today’s rule, millions of people will now have the option of more affordable health insurance coverage. Health advocates have been pushing for this fix for 10 years, and today the Biden administration delivered. Fixing the family glitch is especially important to the health and wellbeing of women and children, who have been disproportionately impacted. It is also key to protecting families from incurring crippling medical debt that undermines people’s health and their credit – impacting their ability to buy a car, secure housing, or even find a job. This rule will provide welcome relief to families across the country who will now find affordable health coverage when open enrollment begins November first.”    

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BACKGROUND 

THE FAMILY GLITCH 

  • Under prior 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.  

  • 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.