Health Care

Health Care

How do health care reform and taxes connect? The Affordable Care Act is single largest change to the tax code in two decades. Find help navigating the complexities of the new health care legislation, Medicare, Medicaid and other medical deductions.

Posts: 1
Registered: ‎04-17-2017


[ Edited ]

I have insurance available through my employer but I chose not to take it because it is half of my paycheck every 2 weeks is this considered unaffordable insurance? I thought it was so we went through the marketplace and got cheaper insurance and now we are being told we have to pay in because we are unable to receive the subsidy. I am so lost on this and I am unable to get a straight answer

Trusted Council Member
Posts: 6,191
Registered: ‎02-23-2016

Re: Insurance

Hi Bandmom14,


Welcome to the H&R Block community.


Whether or not you are eligible for the premium tax credit is officially determined on your tax return, but you estimate your income when you apply for marketplace insurance and what you get up front is based on that.  There are two possible outcomes when you complete your tax return.  The first is that if you underestimated your income you will end up repaying some of the premium tax credit that you received in advance.  The other is that if you overestimated your income you'll get a refundable credit on your tax return.


There are also instant disqualifiers.  If any of the following apply to you then you are not allowed to claim premium tax credit and must repay all of the credit that you received in advance:


  • You filed using the married & filing separately status.
  • You were eligible for health insurance through your employer.
  • Your income is above 400% of the federal poverty line for your family size.

So the main reason why you have to repay your premium tax credit is because you were eligible for insurance through work and because of that you were automatically disqualified for the premium tax credit.  You can still get marketplace insurance, you just can't get any premium tax credit.


Health insurance is one of my areas of expertise, and if you have any other questions I'll be glad to help.



Senior Tax Advisor (Tampa, FL)