Self employed

GeorgeM777 explained well how the Premium Tax Credit is reconciled. The Self-Employed Health Care Deduction will only apply to your actual out-of-pocket premiums paid that were not eligible for reimbursement of premium tax credit.

The amount used for the deduction would be any money you paid over and above the premium tax credit reconciled to you.  

For instance, let's say your insurance cost was $500 per month and you qualified for $400 per month of advanced premium tax credit based on the income you estimated for the year when you applied for the insurance.  You paid $100 per month out of pocket for your insurance.

You can not necessarily calculate your Self Employed Health Care Deduction based on the $1200 you paid out of pocket. You first have to reconcile your credit.

Using the example above:

Based on your actual income for the year and the information on your 1095-A, you actually qualified for $450 per month of premium tax credit. Since you only received $400 per month, but qualified for $450 per month, you will now receive $600 of premium tax credit based on your reconciled amount. Your Self Employed Health Care Deduction will be calculated on the $600 you actually ended up paying out of pocket for the year.

Alternatively, if you used more premium tax credit than you qualified for based on your reconciliation and using the same scenario above:

Based on your actual income for the year and the information on your 1095-A, you actually qualified for only $300 per month of premium tax credit. You will have to pay back $1200 of the advanced premium tax credit you received ($400 advanced - $300 actual x 12 months). Your Self Employed Health Care Deduction will be based on the $1200 you paid out of pocket during the year, plus the $1200 you have to pay back based on your reconciliation. ($100 per month paid + $100 of premium tax credit paid back = $200 per month actual out-of-pocket cost or $2400 for the year)