Those over 55 and 65, before Medicare kicks in.
I see health insurance policies that are quite often over $1000 per month for that age group, with deductibles exceeding $6000. This is at least $18,000 of income, and often over $20,000. Per person.
Whether single or married, then - due to a “cliff rule” - even a single one dollar over the 401% of the poverty line means that the entire ACA subsidy is required to be paid back.
Typically happens over $48,500 if single or $68,000 if married.
Take money out of an IRA or 401k? Get a second job to help pay bills? Start your pension or social security early?
All of these can be enough to require a taxpayer to pay back the entire subsidy - at once, as part of their annual tax return.
I would like to think that the crafters of these laws and rules didn't intend for this massive penalty to continue.
But they Dems have had over a decade to change it - even a little - and have fought tooth and nail to refuse any changes at all.
I know many that have benefited from the subsidies on a personal level, but overall this law has been a disaster, forcing the cost of medicine and premiums to escalate.
And this is the best they can do?
If you knowingly are on the bubble you can choose an HSA plan and that can help with $4500 of income.
I agree there is a problem for that age bracket.
One possible solution for the deductible issue is an alternative health care plan that technically isnt health insurance.
One of the plans from the Christan health sharing programs such as Christian Health Ministries or Good Samaritan.
SInce they arent insurance, and you cant deduct the premiums..it might not violate whatever the clause is about having other “insurance”
I use one of them. Never had a problem with payouts. But I also have not had any large expenditures. Less than 5 grand.
I can back up that claim. My husband started his own business a couple of years ago. IIRC, the cheapest was about 1200 a month, 10K deductible. The only plan even worth purchasing was about 2K a year.
Rather than deal with it, I just went back to work after a long long hiatus. Did a temp job for a year to get some recent "experience" and did the "health sharing" thing.
Thankfully, with the Trump economy I was able to land a decent job after that year with insurance.