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Will Obamacare Health Insurance Subsidies Be Available in 2016? Plus, 5 Important Subsidy Reminders

Will Obamacare Health Insurance Subsidies Be Available in 2016? Plus, 5 Important Subsidy Reminders

Posted Sep 02, 2015 by Jenifer Dorsey

Earlier this year, the King v Burwell lawsuit threatened Obamacare health insurance subsidies in states with federally facilitated exchanges. Many people feared they could lose access to the premium tax credits and cost-sharing reductions that lower their health insurance premiums and out-of-pocket healthcare costs.

However, on June 25, 2015, the Supreme Court upheld Obamacare subsidies.1 This decision ensures that premium tax credits and cost-sharing reductions will remain available to individuals and families who both:

  • Qualify for these subsidies based on income
  • Buy health insurance from a state-based or federally facilitated Obamacare exchange

5 important reminders for Obamacare subsidy recipients

  • Be sure to file your 2014 taxes and Form 8962. Failing to do so may result in having to repay advanced premium tax credits you have already received and losing access to subsidies in 2016 and beyond.

    If you have not yet filed your 2014 taxes and/or Form 8962, take action as soon as possible. You can download Form 8962 and access additional information at irs.gov/uac/About-Form-8962. If you need help submitting it, you can call the IRS at 800-829-0922. Contact a tax professional if you have questions or concerns about filing your 2014 taxes and/or Form 8962.

  • Subsidies are only available for health insurance plans purchased from state-based and federally facilitated exchanges. If you believe you will qualify for this financial assistance and want to take advantage of it, you must shop and enroll through your state’s state-based or federally facilitated exchange.

  • Subsidy eligibility is based on income and family size. Premium tax credits are available on a sliding scale to those whose incomes fall within 100 to 400 percent of the federal poverty level. Cost-sharing reductions that help lessen out-of-pocket costs (e.g., deductibles, copays and coinsurance) are available to those whose incomes fall below 250 percent of the federal poverty level—a silver plan must be purchased to receive a cost-sharing subsidy.

  • You must reapply and qualify for your premium tax credit and cost-sharing reductions every year. While some—but not all—health insurance plans may automatically renew from year to year, your Obamacare subsidies do not. You must reapply to determine your eligibility. Organize your tax and income documentation prior to 2016 open enrollment to help streamline this process.

  • If your income or family size changes throughout the year, you must notify the health insurance exchange from which you purchased coverage. Increases and decreases to your family size and income are likely to impact your subsidy eligibility. If you fail to report these changes, it can mean you receive too much or too little advanced premium tax credit. When you file your taxes, you may owe the IRS for any overpayments. 

What will the cost of Obamacare be in 2016?

Health insurance companies filed their 2016 rates for review in June 2015. The Centers for Medicare & Medicaid Services expects 2016 rates to be approved and finalized by October 2015.3 With news reports projecting double-digit premium increases, many people want to know what will happen to their health insurance rate in 2016. While it is too soon to tell, CMS projects that most people will be enrolled in plans with proposed rate increases of less than 10 percent.4

When 2016 open enrollment begins on Nov. 1, 2015, be sure to use tools such as the Health eDeals Health Care Reform Calculator to estimate your premium tax credit. In the meantime, evaluate your current health insurance coverage, schedule preventive services appointments, and visit healthedeals.com for tips on shopping for minimum essential coverage and supplemental benefits. 

If you are struggling to pay your health insurance deductible and other out-of-pocket expenses, you may want consider supplemental coverage such as Metal Gap. You can enroll anytime. Get a quote at www.healthedeals.com/metal-gap or call 888-839-7679 to speak with an IHC representative.  


The Supreme Court of the United States. King et al. v Burwell, Secretary of Health and Human Services, et al. 576 U. S. ____ (2015). http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf 

Internal Revenue Service. “The Affordable Care Act: What’s Trending.” Last updated Aug. 7, 2015.  http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Affordable-Care-Act-Whats-Trending

Centers for Medicare & Medicaid Services. “Public Review of Proposed Health Insurance Rate Increases for 2016 Coverage Year [Press Release].” June 1, 2015. http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-06-01-2.html 

Centers for Medicare & Medicaid Services. “Public Review of Proposed Health Insurance Rate Increases for 2016 Coverage Year [Press Release].” June 1, 2015. http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-06-01-2.html 

About The IHC Group
The IHC Group is an organization of insurance carriers and marketing and administrative affiliates that has been providing life, health, disability, medical stop-loss and specialty insurance solutions to groups and individuals for over30 years. Members of The IHC Group include Independence Holding Company (NYSE:IHC), American IndependenceCorp. (NASDAQ: AMIC), Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company. Each insurance carrier in The IHC Group has a financial strength rating of A- (Excellent) from A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations. (An A++ rating from A.M. Best is its highest rating.) Collectively, the companies in The IHC Group provide insurance coverage to more than one million individuals and groups. For more information about The IHC Group, visit www.ihcgroup.com.

About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products through general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit www.HealtheDeals.com.