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Any relationship between FPL and eligibility of health insurance

My son had health insurance in 2024 though the marketplace (Obamacare).  His income in 2024 was much lower than expected primarily due to illness.  The reported income on the 2024 tax return may be below the federal poverty limit (FPL).  If so, will the low income jeopardize his eligibility for Obamacare in either 2024 or 2025?  If eligibility remains, will a financial tax penalty be applied other than the routine reporting of the 1095A form?  If yes, how much?

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2 Replies
MaryK4
Employee Tax Expert

Any relationship between FPL and eligibility of health insurance

If his income was reduced because of his illness, it will not affect his ability to obtain the health insurance through the Marketplace, he would just not be eligible for the Advanced Premium Tax Credit, which is applied to reduce the amount he has to pay. 

 

In general, the Premium Tax Credit is available to those who are between 100-400% of the Federal Poverty Limit.  The amount of the credit is on a sliding scale based on income.  For 2024, even if he did fall below the FPL, there is an exception so he will not have to pay back the credit if, at the time he applied, he was expecting to be within the qualified limits.  

 

He will need to adjust the amount for 2025 if he has not done so and his income is expected to fall below the FPL, because the payback would apply for 2025.  

 

I wish him a quick recovery and good health.

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Any relationship between FPL and eligibility of health insurance

Thank you.

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