As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Advance Premium Tax Credits and Cost-Sharing Reductions: A Primer for Assistors
Manatt Health Solutions
Advance Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs) remain critical to the ability of marketplaces to offer affordable coverage. It is especially important that marketplace staff, eligibility workers, navigators, certified application counselors, and other assistors are well-informed regarding the role of APTCs and CSRs in the continuum of coverage created by the Affordable Care Act. While there are numerous regulations explaining how APTCs and CSRs work, much of this information is very technical. This brief, prepared by Manatt Health Solutions, is designed to make it easier to understand APTCs and CSRs at a deeper level. Information provided in this brief includes eligibility criteria, options for using APTCs and a discussion on how the APTC is calculated, and a detailed review of the income measure used to evaluate eligibility.