Joined Medicare, hubby lost subsidy

I can’t find this anywhere so please help. I am retired as is my wife. Under ACA medical care we have a AGI of $48000 and am currently getting a healthcare credit for ACA of $475. This year I will turn 65 and go on Medicare. That means I will be on Medicare and my wife will be the only one on ACA. When I go to the calculator websites they ask for our AGI but when I put it in they calculate her healthcare credit now as $0. My question: I don’t know if the site is in error or does ACA consider our joint AGI as single AGI for my wife only? It seems they would take 50% of our AGI. Or do I just put in my wife’s pension income?

Lloyd in Colorado

Dear Lloyd,

There are several “moving parts” to ACA that account for the subsidy change you are seeing. At $48,000, your household is just over 300% of Federal Poverty. This means that the exchange plan can cost you up to 9.5% of your modified adjusted gross income, or about $4,560 per year. When you were buying coverage for two people from the exchange, your subsidy paid the difference between the (approx..) $4,500 and the cost for a two-person plan. Now that you are buying coverage for only one person, there is less room between the $4,500 that you pay and the total cost. Thus, it is possible that your subsidy for your wife’s coverage is $0, if the plan she chose costs around $375 per month.

Your outlay for your wife’s plan certainly should not be half of your adjusted gross income. (And your household income does not change – it includes both yours and your wife’s income – no matter how many people you are buying coverage for.) That sounds like an error by the calculator site. For a reliable calculator, try the Kaiser Family Foundation’s site (http://healthreform.kff.org/subsidycalculator.aspx?source=QL). I put in your information and got a $28 per month subsidy.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.