There are currently 13 states and the District of Columbia that have their own state-based health insurance marketplaces, also known as state-based exchanges, as an alternative to the federal marketplace. These states are:
- District of Columbia
- New York
- Rhode Island
These states have some level of autonomy in terms of the plans offered, the rules and regulations, and the subsidies provided to the residents.
For example, some states have expanded Medicaid coverage to a higher income level than the federal level, which affects the eligibility for Premium Tax Credit. Additionally, some states have their own subsidies, in addition to the federal credit.
In California, for example, the state provides additional subsidies for low-income individuals and families, as well as additional financial assistance for those who face high out-of-pocket costs. Similarly, in New York, the state provides additional subsidies for individuals and families with incomes between 200% and 400% of the federal poverty level, which can affect the amount of the Premium Tax Credit they’re eligible for.
It’s important to check the rules and regulations specific to your state to determine your eligibility for Premium Tax Credits and health insurance coverage. You can visit the website of your state-based marketplace or consult with a local insurance agent or tax professional to get more information about state-specific rules and regulations and how they affect federal Premium Tax Credits.