The 400% Rule For Health Subsidies

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Dennis Jarvis

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Apr 28, 2013, 8:50:04 PM4/28/13
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Dennis Jarvis

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Article Title: The 400% Rule For Health Subsidies
Author: Dennis Jarvis
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Soon, we'll all know what our 400% of the Federal Poverty Level is. It's going to dictate whether you are eligible for potentially 1000's of dollars in health subsidies per year starting Jan 1st, 2014. That's a big deal especially with the ever escalating cost of health insurance (sure to continue increasing as we go forward). Let's look more closely at the 400% rule and how it impact whether you can expect to receive a subsidy.

How does your income compare to the Federal Poverty Level?

Many Americans are not aware of the Federal Poverty Level because they don't come close to qualify for the various Federal and State programs that use the FPL as a qualifier. Making 100% of poverty is approximately $11K per year for an adult and that's essentially minimum wage. The Health Reform ACA bill will change that significantly by using multiples of the FPL to determine eligible for health subsidies and other benefits. In fact, the ACA bill sets the cap at 4 times the FPL or 400%. This means that you can qualify for significant health subsidies if you make up to 4 times the Federal Poverty Level amounts. In the case above, this means that a person can make up to approximate $44K annually and expect to qualify. That's a lot of Americans! Now we're up to almost $4K monthly or $25/hourly. That's a wide net indeed.

Family members increase the basis for the 400% rule

The FPL is based on size of family. An individual person may be approximate $11K while a family of four might be $23K (you can find exact Federal Poverty Levels). We have to then multiply that $23K by 4 (400%) and we get $94K. That means a family of four that makes under $94K will likely qualify for a health subsidy! That's a big number and it should apply to many families across the United States. Here's the 2013 FPL limits: http://healthsubsidy.net/400_Percent_Rule_and_health_Subsidy.html

Important aspects of 400% rule for health subsidy eligibility

The 400% rule is interesting in that it's a fix line in the sand. If you make 401% of the FPL, there's no subsidy. The period of time is supposed to be the prior year's income. For example, 2012 tax filing will drive 2014 subsidy eligibility. Passive income will be included and the 400% is based on a person's MAGI (Modified Adjusted Gross Income). The modified adjusted gross income is found by taking the individual's adjusted gross income and adding back certain items such as foreign income, foreign-housing deductions, student-loan deductions, IRA-contribution deductions and deductions for higher-education costs.

There are other requirements for health subsidy qualification but the 400% income level is by far the big determining factor for millions of Americans being able to qualify for $1000�s of dollars each year. This will continue to gain more recognition as people become aware of the significance of this number. Keep in mind that if income changes above the 400% limit, it can affect amounts to be paid back (from subsidies received) at tax time of the following year.


About The Author: Dennis Jarvis is a licensed health insurance agent who focuses on helping people understand the new health subsidy available through Reform for health care. http://www.healthsubsidy.net

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