Am I eligible for “Obamacare”?

It’s about that time when open enrollment for insurance plans starts rolling around. With so many middle and low-income families having difficulties due to the economy, the question of what to cut from the budget first always comes up. In most cases, it’s health insurance. One of the best alternatives is the Affordable Care Act, also known as Obamacare.

Am I eligible for Obamacare?
Eligibility for this program relies on a few things, because coverage and eligibility may differ based on the state in which you reside. In most cases, you qualify if:

  • You live in the United States
  • You are a United States citizen or in the country by legal means such as LPR (Lawful Permanent Resident) or LTR (Lawful Temporary Resident)
  • You are not incarcerated
  • You have an income that is 100% above the federal poverty level

Individuals may also qualify who are Cuban or Haitian entrants, under Temporary Protected Status (TPS), are in the country on a student or work visa, or are in the country under asylum or have refugee status.

Getting a Tax Credit Subsidy
There are ACA premium subsidies (tax credits) for individuals and families with net incomes between 100% and 400% of the Federal Poverty Level (FPL). Additionally, the American Recovery Plan Act (ARPA) has expanded coverage through 2022, and then the Inflation Reduction Act (IRA) has further extended coverage from 2023 through 2025.

Qualifications for Obamacare
To get the premium tax credit, you must be an American citizen or legally present non-citizen living in the U.S. and do not have access to other affordable health insurance under an employer-sponsored group health plan, Medicaid, or Medicare. “Affordable” is defined as insurance that is not more than 9.61% of your household income in 2022 and 9.12 percent in 2023.

Income levels are adjusted each year as poverty rates are adjusted for inflation. If you do not have affordable health coverage through your employer, the likelihood of being able to qualify for Obamacare marketplace plans is increased. Using a health insurance marketplace calculator can also help determine if you qualify for a plan under the health insurance marketplace.

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