General Q re: ACA expiring Extended Tax Credits
I am trying to help my brother navigate his insurance coverage through ACA and the expiring of extended tax credits. Facts
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He looking for a job that can provide health insurance but has been having difficulty finding one that pays enough at this time. He works as a substitute teacher during the school year and retail during the summer. Due to concussion impact he cannot work as a regular teacher at this time, maybe never again (impairments are complicated but he does very well as a sub). Lives in small apartment. Still has student loans.
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He currently has gold plan and with tax credits he pays $500 a month ($290 tax credit). He already cannot afford $500 a month and our family has been chipping in monthly to cover $250 of it. He is using food shelves regularly and trying to just get by. In 2022 when he started ACA he was on bronze but 2 ICU stays and cascade of health changes - Gold was suggested as better option due more complex medical situation. I encouraged him to do ACA plan a few years ago. He unfortunately thought he got a super deal with non ACA compliant "junk" insurance that covered nothing really prior to ACA. SO far the ACA plans have saved his life. No doubt. He does not qualify for Medicaid.
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he has 2-3 very serious , potentially life threatening medical conditions, that he must continually manage and sees several specialists a year and has 12 prescriptions a month. These evolved just in last few years. He is not considered disabled. He has not pursued that route either as that doesn't fix the present moment concerns and can be long road to go down. Unlikely he would qualify regardless. Conditions are very well managed because he has access to care.
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I have spoken to our state's marketplace plan on his behalf. They have been extremely helpful. The general info I am getting is that they have no idea what the final increases to premiums will be at this time and won't know until much closer to enrollment. I asked them about Silver Cost plan sharing - however even that was up in the air as to costs. He will not be able to afford Gold ( we cannot contribute any more to his premium), But concern he won't be able to afford Silver as it may leave him underinsured given is health. Going without insurance cannot be an option. He is scared.
Would Silver Plan be the only and best option until he can secure a job that pays at least $27 an hour and has decent benefits? Is there more accurate info out yet on anticipated rate increases?
Any gamble that Congress may restore the tax credits? Probably not....
Thanks . Sorry about the long post
Posted Aug 7, 2025, 12:55 AM UTC