^^That’s what I mean. You aren’t getting it.
When you go to the marketplace you enter your expected household income. Let’s say you expect to make $60k. The prices that you are shown for each plan available are what you will pay per month, and also how much the government is paying for you. The cut off is around $64k. Make a penny more and the subsidy disappears in full. If you expected to make $60k, and wound up making $65k you owe the entire subsidy back at tax time, because you made more than the max allowable $64k.
2018 the subsidy was over $700 a month on the plan you picked. So, making the $5k too much means you owe back $700X12. You would be better telling the job to keep a thousand bucks so you don’t owe the $8,400.
Example 2: A couple has one spouse who is self employed, and the other spouse was laid off and looking for a job. The self employed spouse makes $40k. They go to the marketplace and choose insurance that they pay $200 a month, and the government pays $900. Then, he gets a job in June and now they can switch to healthcare at his job. In the half year he makes $40k. Now, they’re over the top threshold, and owe every penny back of the ACA subsidy that they used, so $900×6.
Every year the subsidy has gotten more and more huge, because the insurers raise their premiums, and the government just pays up, so the people needing healthcare insurance, like me, pay around the same, UNLESS, they go over the threshold, then they are paying full price. Some people are obviously paying the full price to begin with, because they simply make too much money and they know it at the beginning of the year. Others, similar to me, know we hover right around the $60k-$70k mark, and it’s a torture.
What irks me most is the premiums are ridiculously high and the insurers are having huge profits and the government is just letting it happen. My insurance is over $1100 a month this year, 2019, and I have a $15,000 deductible! That’s disgusting to me. I am getting the subsidy, because we sold our business and are making well below the threshold, but my husband is actively looking for work, so most likely we will wind up going over. If he gets a great job in his field then I’ll get over it, but if it’s some sort of bandaid job that puts us at that $60k something mark again, and I wind up paying back $10k then I almost rather he didn’t work. It’s just such a huge number, and it shouldn’t be.
That’s why republicans say “hand outs” cause people to game the system, because they game it themselves. Do you know how many people with money do everything they can to get rid of their money so they can get Medicaid? Lawyers advise on these strategies to people who have quite a bit of money.
I wish there was insurance available to me just for catastrophic. For some reason I can’t find that like I had 25 years ago. I’ll pay for every doctors appointment and tests, I do that now, but if I have a major event I want the insurance to kick in, and that should not be $1,100 a month, because catastrophic things aren’t likely to happen. That’s why the insurers are making a fortune.
The Democrats fighting for ACA like it’s a miracle don’t understand how it works. It needs to be fixed. Possibly, it’s better in some other states. Where I live only BCBS was available in the marketplace in 2017 and 2018. No competition. In 2019 a company I never heard of was competing, but it made me nervous when I read reviews.