IRS Finalizes Rule to Fix the ACA "Family Glitch"

The IRS has finalized proposed regulations that are designed to change the ACA rules governing premium tax credit eligibility. The final regulations provide that the affordability of employer-sponsored coverage for the employee's family would be based on the amount the employee would be required to pay to cover both the employee and eligible family members, rather than the individual employee alone. Typically, employees are only eligible for a premium tax credit if their employer fails to provide "affordable" health coverage. "Affordability" is based on whether the employee contributions for self-only coverage exceeds a percentage of the employee's household income (as indexed for inflation). Under the prior rules, if self-only coverage was affordable for the employee, coverage was also deemed affordable for a spouse and dependents (so that the spouse and dependents would not qualify for the premium tax credit). Under the new rule, family members are disqualified only if the cost of family coverage is less than the annual threshold. "Family coverage" means any employer plan that covers related individuals other than the employee (including self-plus-one plans). The regulations also create a separate minimum value rule for family members, so that they do not lose premium tax credit eligibility if the employer plan does not provide minimum value to the family members (regardless of cost). The regulations are effective for tax years beginning after December 31, 2022. For more information on the premium tax credit, visit Tax Facts Online. : Q 8883. Note: Q is updated.