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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsQuick question: Anyone know what happens if I make less than I estimated to the ACA exchange?
Due to an injury to my husband, our income will be greatly reduced this year. He's self employed and now my estimated was way off. What happens to us now? We may actually fall below the poverty level due to my having to take off work to take care of him and transport him to appointments. My state did not expand Medicaid, or I'd not be so worried.
We'll be OK overall, were extremely fortunate. Our house and vehicles are paid for and I'll make enough to cover all the basics like food, utilities and insurances even with all the added time off. It's just I might not make enough to keep us profitable on paper due to his work expenses already this year.
Will we lose our ability to have access to healthcare since I (accidentally) overestimated this year? Next year our income will be improved, but it's looking like it's in the tank for the better part of this year.
My thanks to anyone who knows.
uppityperson
(115,677 posts)Including income. Does your state have an insurance marketplace page?
herding cats
(19,565 posts)I'm in Texas. They did nothing but hinder the process, hence my concern.
uppityperson
(115,677 posts)I underestimated and ended up paying via income tax refund. It seems if you pay too much, they won't care.
I think you mean you said you'd make more than you are, and hence pay more than you should.
herding cats
(19,565 posts)I don't mind my premiums I just wasn't sure if they'd be upset if I actually ended up in what would be Medicaid eligible (which means zero coverage here) when I estimated differently.
Honestly, it would be better if I lied about my income and paid higher premiums and taxes than lose my insurance right now.
Rstrstx
(1,399 posts)The healthcare website used to tell you if anything you should overestimate your income slightly if you don't want an unpleasant bill at the end of the year.
If you end up below the Federal Poverty Level at the end of the year you should be ok (at least you used to be) according to Kaiser. This article is old but the IRS guidelines are still in effect: https://khn.org/news/consumers-whose-income-drops-below-poverty-get-break-on-subsidy-payback/
RussBLib
(9,020 posts)Most people won't be in your situation so don't know. If you are on the ACA now and your income is reduced mid-year, you should be eligible for a bigger subsidy, but it may not be levelled out until you file 2018 taxes.
herding cats
(19,565 posts)We have surgery tomorrow, so it'll be a Monday or so, but this is worrying me to the point of distraction.
Thank you!
still_one
(92,219 posts)insurance premium, that overpayment should be added to your tax refund if they receive one, or reduce the amount of tax they owe.
Regardless, they need to speak with a healthcare navigator per your suggestion.
BigmanPigman
(51,610 posts)They will do the calculations and tell you how much your new rates are and that will be applied to the next year's ACA info to be used at tax time. I asked my ACA person, "What happens if the govt makes more changes in the ACA? When will the changes go into effect?". I was told that any changes to my costs, etc. will go into effect during the next calendar year. I don't know what the rules in TX are.
herding cats
(19,565 posts)Right now I'm thinking I'll just get a second job after my husband is able to be alone and pad my income as much as possible. I may be able to make up most of it in the last quarter that way.
TwistedTinkerbelle
(137 posts)My husband and I had this same question. We have the good fortune to have a son who is a tax accountant for a tax lawyer. We were told to over estimate our income a bit to protect us if my husband wound up having to work mandatory overtime. If we go in under the amount we we thought we might make it will be used to offset the amount of tax owed or we'll be refunded some of it as an over payment.
If you have a tax preparer you trust and can call, ask them. I get not wanting to deal with the ACA customer service, but they can help, just make sure they understand what you want to do.
I hope you can get it cleared up soon.
Pinkflamingo
(177 posts)I had a very similar problem in 2016. I ended up making much less than I had anticipated. Nothing at all happened.
Im in Florida, which is also very anti-Obamacare.
From what I understand from my accountant, if you make a mistake the other direction, that is, you make more than youd anticipated, then you will be billed.
Hope the surgery goes well. Strike this worry off your list for now.