The way it works is this:
Each taxpayer has an annual contribution towards their health insurance. This contribution is calculated on form 8962 (see line 8a).
The Marketplace uses this amount to calculate how much subsidy it needs to provide towards your insurance premium. As you may know, the insurance in the Affordable Care Act is "affordable" because the government pays part of the premium, with you paying the rest, depending on your calculated annual contribution. Note that the money from the Marketplace is sent straight to the insurance company.
Of course, line 8a is based on your estimate of your annual income. At the end of the year, there is a reconciliation that compares your estimated income for the year with your actual income for the year. This changes what your annual contribution should have been.
If your annual contribution should have been higher, then the Marketplace overpaid the health insurance company, and you need to pay the government back for some of that. If you end up making less money that what you estimated at the beginning of the year, then you get a refund of some or all that you paid.
So you need to decide at the beginning of the year if you are going to apply for Medicaid or not. If you stick with the Marketplace plan and overestimate your income at the beginning of the year, at least you should get back some or all of what you paid for the health insurance premiums.
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