2024 Cost Assistance Obamacare

Everything You Need to Know About Obamacare Cost Assistance For 2024

We cover everything you need to know about cost assistance for 2024 health plans under the Affordable Care Act (ObamaCare).

In other words, here is everything you need to know about Premium Tax Credits, Cost Sharing Reduction Subsidies, Medicaid and CHIP, HSAs, and Medical Deductions for plans purchased during open enrollment 2024 all in one page.

Types of Assistance

First off, the types of assistance offered under the Affordable Care Act are:

• Premium Tax Credits
• Cost-Sharing Reduction Subsidies (Silver Plans only)
• Medicaid Expansion and CHIP
• HSAs (Health Savings Accounts) and Medical Deductions

Next, the chart below offers a quick overview of ObamaCare’s cost assistance options by “MAGI” income for 2024.

NOTE: Medicaid/CHIP eligibility will be updated when the new Federal Poverty level data is published in early 2024.

TIP: Want to find out what you can save quickly? Check out our Subsidy Calculator.

The Federal Poverty Guidelines Used in 2024

Below are the 2023 Federal Poverty Guidelines that went into effect in early 2023 (the ones you use for 2023 Medicaid/CHIP and for 2024 marketplace cost assistance).^[1]

These guidelines are the key to all cost assistance under the Affordable Care Act. Specifically, these guidelines are used for:

• Medicaid/CHIP between late Jan 2023 – Jan 2024 after the poverty level guidelines are published (exact dates subject to change each year).
• 2024 marketplace cost assistance on all marketplace health plans held in 2023 – 2024 and purchased during open enrollment for 2024 (which runs from November 1, 2023, to January 15, 2024).
• For special enrollment in 2024.
• For ACA taxes filed for the 2024 calendar year (filed in 2025).

NOTE: Our federal poverty guideline list has a 100% poverty level, 138% Medicaid expansion threshold, 250% CSR subsidy threshold, and 500% premium tax credit thresholds. This lets you see at a glance see what assistance you qualify for. Please note that for Medicaid Expansion, if you make under 138%, you qualify. For CSR, it is between 100% – 250%. And, for tax credits, it is between 100% and 500%. See details on subsidies under the ACA.

IMPORTANT: Until 2025, there is no limit on premium subsidy caps.

TIP: For mobile and smaller screen sizes, drag the table below to scroll and see the different poverty levels.

The following guideline figures represent annual income.

NOTE: Alaska and Hawaii use different guidelines (see below).

For families/households with more than 8 persons, add $6,430 for each additional person.

For families/households with more than 8 persons, add $5,910 for each additional person.

FACT: The Federal Register notice for the 2023 Poverty Guidelines was published on January 19, 2023.

Details on Each Assistance Type

Below are details on each type of cost assistance for 2024 health insurance under the Affordable Care Act.

Medicaid and CHIP

In all states that expanded Medicaid, adults making below 138% of the poverty level qualify for Medicaid. Other states have unique eligibility. CHIP eligibility tends to be higher but differs by state.

You can sign up for Medicaid and CHIP 365 days a year.

You may qualify for free or low-cost care for Medicaid based on income and family size if you make 138% of the poverty level or, for example, $20,120 for an individual or $41,400 for a family of four for Jan 2023 – Jan 2024. Specifics may differ by state.

Contact your state Medicaid office or use the marketplace for details.

TIP: Starting in late Jan / early Feb each year new guidelines are published. After the new guidelines are published in 2024 you’ll use those for Medicaid and CHIP.

The Premium Tax Credit Subsidy Caps By Percentage of Household Income for SLCSP 2024

Premium tax credits are tax credits that can be taken in advance as Advanced Premium Tax Credits or at tax time as Premium Tax credits (or you can do a mix). Premium tax credits cap premium spending for a family based on MAGI income compared to the federal poverty level and are based on the cost of the second-lowest silver plan (SLCSP) in a state’s Marketplace. To qualify, you must purchase a marketplace plan.

The chart below shows the minimum and maximum percentage of the household income that a person will pay for that plan. The amount you’ll pay is based on your household income (compared to the federal poverty level) and is adjusted based on the price of the plan chosen.

NOTE: For 2021 – 2022, Section 9661 of the American Rescue Plan capped marketplace health insurance premiums. Not only did it provide lower caps for those who got subsidies through cost assistance, but it also capped the premium that can be charged to the benchmark plan at no more than 8.5% of household income. Even without subsidies, you can’t pay more than 8.5% of household income for a benchmark health plan.

NOTE: To qualify for tax credits, you must make between 100% – 400% of the poverty level (FPL). If your state expanded Medicaid, you will be eligible for Medicaid instead of tax credits below 133% (or 138% adjusted) FPL. However, please note, that those who aren’t eligible for Medicaid expansion and who are on unemployment can get marketplace assistance under the American Rescue Act.

Cost Sharing Reduction Subsidies 2024

Cost Sharing Reduction (CSR) subsidies reduce your out-of-pocket expenses on silver plans purchased through the health insurance marketplace for those with incomes between 100% – 250% of the poverty level.

CSR subsidies lower your coinsurance, and lower copays, deductibles, and maximum out-of-pocket costs you will pay in a policy period.

There are three levels of CSR subsidies: CSR 73, CSR 87, and CSR 94. The numbers refer to the actuarial value (AV). Benefits sheets will include different summaries for different CSR levels.

Please note values may adjust slightly each year. However, they are typically around the figures displayed below.

Income Level Actuarial Value (the costs a Silver plan will cover due to cost-sharing reduction subsidies for % of the Poverty Level).

• 100-150% FPL = 94% Actuarial Value (CSR 94)
• 150-200% FPL = 87% Actuarial Value (CSR 87)
• 200-250% FPL = 73% Actuarial Value (CSR 73)
• More than 250% FPL = 70% Actuarial Value

NOTE: For more information, see the 2024 Actuarial Value Calculator.

NOTE: Actuarial values are subject to change each year. The % numbers above may be adjusted before open enrollment.

Out-of-Pocket Maximums and Deductible Limits For 2024

Each year, the ACA sets new limits for out-of-pocket maximums and deductibles. Here are the limits for 2024 plans for individuals and families.

• $9,450 for self-only coverage ($9,100 in 2023)
• $18,900 for family coverage ($18,200 in 2023)

NOTE: For 2024, your maximum deductible is the same as the out-of-pocket maximum.

NOTE: The individual limit applies to each individual in the plan. Thus, for 2024, even though the family limit is $18,900, no one member can incur more than $9,450 in covered expenses before the maximum is reached for that member.

NOTE: See Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2024 for final levels.

Maximums and Deductibles on HSA-Eligible Plans in 2024

The maximum and deductible requirements for HSA-qualifying plans are not the same as maximums and deductibles on health plans in general. Below are the HSA limits for 2024.

HSA Chart for 2024

First off, here is an easy-to-read 2024 HSA chart that sums up HSA minimums, maximums, and limits. See detailed information below.

Minimum Deductible for HSA Eligibility 2024

• $1,600 for self-only coverage ($100 increase from 2023)
• $3,200 for family coverage ($200 increase from 2023)

NOTE: The minimum deductible is the minimum deductible your High Deductible Health Plan must have after cost assistance.

Maximum Out-of-Pocket Limit for HSA Eligibility 2024

• $8,050 for self-only coverage ($550 increase from 2023)
• $16,100 for family coverage ($11,00 increase from 2023)

NOTE: The maximum out-of-pocket is the highest maximum a plan can have to qualify for an HSA.

TIP: The maximums are slightly lower on HSA-compatible plans than they are in general on health plans. This has to do with the fact that different mechanisms raise the rates. The difference allows for non-HSA compatible high deductible plans. Thus, if you want an HSA, make sure your plan is “HSA Eligible.”

HSA Contribution Limit for 2024

• $4,150 for self-only coverage ($300 increase from 2022)
• $8,300 for family coverage ($550 increase from 2022)

NOTE: 55 plus can contribute an extra $1,000.

TIP: See Rev. Proc. 2023-23 for final HSA levels.

The Medical Expense Tax Deduction for 2024

Medical expenses are deductible if they exceed 7.5% of your AGI (adjusted gross income), although certain rules apply. This number as bounced between 7.5% and 10% in recent years, but is 7.5% for the 2024 tax year.

1. A Notice by the Health and Human Services Department on 01/19/2023. Federalregister.gov.