Q:

How is eligibility for ObamaCare determined?

A:

Quick Answer

The income of the applicant or applicants determines their eligibility for subsidies under the Affordable Care Act, or Obamacare, according to Obamacare Facts. Applicants making up to 400 percent of the federal poverty level are eligible for subsidies. The federal poverty level adjusts each year for inflation.

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Full Answer

Applicants making under 400 percent of the federal poverty level are eligible for a range of tax credit subsidies, reports Obamacare Facts. More extensive subsidies are eligible for applicants who make under 250 percent of the federal poverty level, who qualify for the cost-sharing reduction subsidies on Obamacare silver plans. Individuals making under 138 percent of the federal poverty level are eligible for Medicaid in states that expanded Medicaid under Obamacare.

In states that did not expand Medicaid, individuals making under 100 percent of the federal poverty level but above 48 percent fall into what some term the "Medicaid gap," according to Obamacare Facts. This gap mostly affects adults because most states offer children health insurance programs for low-income children. Individuals in states without expanded coverage who fall into this gap are exempt from the mandate to obtain insurance and do not receive a fine. They may also apply for health insurance at healthcare.gov under a hardship exemption and qualify for catastrophic coverage.

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