Fact Sheet: Fixing the Family Glitch in California — Projections from the California Simulation of Insurance Markets

Summary

Many Californians struggle to afford job-based coverage, especially family coverage. Under the original ACA regulations, workers whose coverage for themselves only cost more than 9.61% of household income (in 2022) could receive subsidies to enroll in Marketplace coverage, along with their family members. However, if coverage for the worker only was affordable no one in the family was eligible for subsidies, even if the cost of family coverage was unaffordable. The spouse and children of the worker are said to fall in the “family glitch”—unable to access subsidies in the individual market, and offered family coverage through an employer that was unaffordable. Proposed federal regulations would fix the family glitch by extending subsidies to spouses and children offered unaffordable family coverage through an employer. In this fact sheet, we use the California Simulations of Insurance Markets (CalSIM) model to project for 2023 how many people would fall into the family glitch in California, how many would be newly eligible for a positive dollar subsidy, and how many would enroll in Covered California with subsidies under the family glitch fix.

Read the fact sheet.