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Calculators and Calculations
Home›Calculators and Calculations›How to Calculate ACA Affordability in 2023

How to Calculate ACA Affordability in 2023

By Matthew Lynch
October 14, 2023
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Introduction:

The Affordable Care Act (ACA), also known as Obamacare, is designed to ensure that all Americans have access to affordable health insurance options. As 2023 approaches, it’s essential to understand how ACA affordability is calculated to make informed decisions regarding your healthcare coverage.

Here’s a step-by-step guide on how to calculate ACA affordability in 2023:

1. Determine your household income:

Your first step is to determine your household income. This figure generally includes earnings from all family members who are also part of your tax-filing unit. The ACA considers Modified Adjusted Gross Income (MAGI) as the basis for calculating affordability, which includes wages, Social Security benefits, and some types of unearned income such as dividends.

2. Check the Federal Poverty Level (FPL):

Once you’ve determined your household income, compare it with the Federal Poverty Level (FPL) for 2023. FPL guidelines are updated each year by the Department of Health and Human Services (HHS) and are used to determine eligibility for premium tax credits and cost-sharing reductions. These guidelines differ depending on the size of your family.

3. Calculate the maximum percentage of income towards insurance premium:

ACA guidelines dictate that families should not spend more than a certain percentage of their income on health insurance premiums. This percentage depends on where your household income falls in relation to the FPL. In 2023, if your household income is between 100% and 400% of the FPL, you might be eligible for premium tax credits that limit your contribution towards insurance premiums.

4. Identify any available premium tax credits:

Premium tax credits aim to help eligible individuals and families with lower incomes afford health insurance purchased through the Health Insurance Marketplace or state-based exchanges. To determine the amount of premium tax credit you might be eligible for in 2023, access the Health Insurance Marketplace Calculator available on healthcare.gov or seek help from a healthcare navigator.

5. Find the second-lowest-cost Silver plan available:

The amount of premium tax credits you receive will be tied to the second-lowest-cost Silver plan available in your geographical area. To find this plan, visit healthcare.gov or your state-based exchange and compare available plans for your coverage needs.

6. Calculate your contribution towards premiums:

To determine your financial contribution towards monthly insurance premiums, multiply your annual household income by the applicable percentage (as determined in step 3). Divide the result by 12 to get your monthly contribution.

7. Deduct potential premium tax credits:

Subtract the premium tax credit amount (step 4) from the cost of the health insurance plan you’ve chosen. Ideally, this should be equal to or lower than your calculated contribution in step 6. If it’s more than this amount, consider selecting a lower-cost plan or explore other options within ACA guidelines.

Conclusion:

Calculating ACA affordability in 2023 is a crucial step towards ensuring you and your family have access to affordable health coverage. Take advantage of available resources like healthcare navigators, online calculators, and official government websites to make informed decisions about your healthcare options.

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