PSA - If you opt out of the ACA next year

[B2G]

the amount you have to pay will rise.

******************************************************************

The fee you pay if you don't have health coverage

The fee for not having health coverage is calculated one of 2 ways. If you or your dependents don’t have insurance that qualifies as minimum essential coverage you'll pay either a percentage of your household income or a flat fee -- whichever is higher.

The fee in 2015

If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:
•2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
•$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay one of these two amounts when you file your 2014 federal tax return:

•1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.


•$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.


The fee after 2015

The penalty increases every year. In 2016 it’s 2.5% of income or $695 per person. After that it's adjusted for inflation.

How you pay the fee

You’ll pay the fee on the federal income tax return you file for the year you don’t have coverage. Most people will file their 2014 returns in early 2015 and their 2015 returns in early 2016.

Learn more about the individual shared responsibility payment from the Internal Revenue Service.

https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/

[Travis_0004]

1. Dont pay the tax

The IRS has no enforcent powers on this tax. They can write you a stern letter, take your tax refund, which I dont get anyway, and thats about it. They can not garnish your wages, or even sue you in court.

[Recursion]

2. But you still won't have health insurance (nt)

If you want a more progressive party, f

[Man from Pickens]

99. I think it's time to get a grip on the problem not being insurance

it's that "running up the bill on sick/helpless people" is the game

every year they find new ways to get away with it, so every year they jack the prices up again and again and again

billing practices in medicine are so grossly and horribly twisted, that they would be illegal in any other industry

[B2G]

3. The rub is in the return

A lot of low income people get one.

[Travis_0004]

4. Plan B. Dont pay your power or water bill

After 60 days or so you will get a shutoff notice. That notice qualifies you for a hardship exemption. Once you get the notice get current on your bill. The small late fee is cheaper than the healhcare tax.

[daredtowork]

5. Ah, gaming the system

This is what makes it so hard to do anything.

We completely undermine the ACA through our fun little games - and then what? Back to the old ways of the insurance company "free market"? We will only get to evolve to universal healthcare if the ACA *succeeds*.

[BlindTiresias]

8. Lol

Poe's law in action.

[daredtowork]

9. Spoken like a dedicated freeper. nt

[BlindTiresias]

12. Who is the freeper?

The socialist or the guy who loves private mandates to enter markets? Which one is more right wing?

Hint: It is you.

[daredtowork]

15. The freeper is the person who cheats and exploits

to get what's best for themselves at the expense of the rest of society.

The person who wishes to reallocate resources toward infrastructure, public services, and the greater good of society is simply using policy to return resources where they belong.

[BlindTiresias]

17. Oh good

Then you should probably dislike how the ACA was implemented, then, as it forces people to buy insurance and thus was a huge gift to the free market entities known as insurance companies. Doesn't sound like returning resources to where they belong at all.

[daredtowork]

23. I realize that

I hate that the ACA is a gift to the Insurance companies. But "defunding Obamacare" isn't going to help anything. We need to move forward, not backward.

[BlindTiresias]

25. That is nonsense

You don't get a leftward policy by enacting a rightward policy. There is no incremental mechanism for it go in any direction but where it is currently at. A good selling point, but utter nonsense.

[daredtowork]

29. But that was Obama's selling point

Obama sold the ACA on "we will start with this" and get more later.

Your point may be "Obama lied", but I choose not to believe that.

[BlindTiresias]

34. No, my point is

The current structure and composition of government turned the ACA to what it is, I don't know how much of a hand Obama had in that and I don't care. That same structure is intact and now that insurance companies in possession of a captive market, you can bet they won't be letting go of that. You can't elaborate on an incremental mechanism to change this because there is none.

[daredtowork]

37. I agree that sucks and needs to be addressed. nt

[BlindTiresias]

45. Except it won't be

As I said, as appealing as the "change it later" argument is to someone nobody I have seen make that argument has established the means by which it is possible and, furthermore, how it is possible now with a captive market for insurance entities who are going to fight it twice as hard now.

No, the ACA as it was drafted was a terrible idea and likely permanently cemented the insurance companies as a central component of the American healthcare system. They will be impossible to get rid of now.

[daredtowork]

67. What do you suggest? nt

[BlindTiresias]

68. Nothing

It is too late now, they are fully entrenched and aren't going anywhere. But I also don't pretend that this is the incrementalist path to some kind of UHC system or more control over the insurance companies.

[CreekDog]

49. so I would be better off with insurance that didn't cover preexisting conditions?

let me know.

[BlindTiresias]

51. naw

You would have been better off with actual UHC of some kind or at least singlepayer.

[CreekDog]

54. UHC/Single Payer is not one of the options offered or are you suggesting i drop insurance

and sign up for UHC/Single Payer?

what do i use in the meantime?

[BlindTiresias]

56. I am saying the policy was not good

This is not a problem than can be isolated to some individual choice on what to do, the policy was not well crafted from the get go. I'm glad you are fine with your insurance, but it was a sub-optimal solution.

[VanillaRhapsody]

31. actually as a beneficiary...I LOVE IT!!!

[BlindTiresias]

36. I'm glad you love being a captive to market entities

Other people are not so servile.

[VanillaRhapsody]

39. I am not captive! I was on unemployment WITHOUT health insurance 2 yrs before that!

I can tell you this....it is a HELLUVA lot better with it than without!

Captive my ass.....I am going to go back on it and stay on it from now on!

How do you think companies like Uber are working?....People can afford Health Insurance and work for themselves!

[BlindTiresias]

40. Servile.

[VanillaRhapsody]

41. SAYs you!

So you are self sustaining? Off the grid are ya? Going Galt? NO?

Then who are YOU a slave to?

[BlindTiresias]

42. Sorry

Anyone who LOVES being forced to buy insurance from a private entity just for existing is servile. Apparently that means you, so be it.

Being forced to and wanting it to be different = not servile.

Being forced to and loving it = servile.

See the distinction?

it is the difference between a prisoner who longs to be free and a willing slave.

[scarystuffyo]

44. I got mine!!!!!!! The hell with the ones still suffering

Nice progressive attitude


You should be commended .........

Hats off

[VanillaRhapsody]

46. I Got Mine and YOU can get yours too!

nobodies stopping you...


if you make up to around $20 an hour and single....you qualify for subsidies on the Exchange....

Get you some!

[scarystuffyo]

52. I have insurance and have compassion for those struggling with it during these times

You know you can do both

Not everyone is a liar when they say their premiums are going up or
they can't find a doctor close enough who will even accept the crappy insurance
they had to buy being it was the only one they could afford.

[VanillaRhapsody]

53. who is struggling....if you make under $40 grand a year....you get subsidized...

its that simple.

I was on unemployment (just over $300 a week). I was subsidized 90%....I paid $61 a month for a Silver Blue Cross plan. $10 copays...(plus all the freebies)

[scarystuffyo]

63. I have Blue Cross also and it's a good insurnace

There are people who could only afford the bronze plan with
big copays , it might not seem like a lot but when you have to pay $25
out of pocket every time for a prescription it's hard for many folks

Blue Cross is one of the best but not every state offers it.
Also when people look at which doctor will accept the insurance they bought.

They find out there are none in their town , they have to put the mile limit at 50 to 75miles

You got lucky in where you live , that's really all it was

[VanillaRhapsody]

74. I paid $61 a month on a $300 a week Unemployment check....

that was for Silver....sorry but your protestations are falling flat. With THAT income I was subsidized at 90%


You get sick or break a bone....you will be damn glad you paid for that! (very low out of pocket max)

[scarystuffyo]

77. Did you have the other $6000 in the bank saved up if you broke a bone?

Or were you just not planning on paying it .....

[VanillaRhapsody]

78. I had insurance.....

why would I need $6 grand.

By the way...I had a broken wrist that required surgery for plates and screws last year.

[scarystuffyo]

79. You have a deductible on your policy? most have between 4000 to 6000

If you are on the hook for that it carries on to next year and forever unless you declare medical bankruptcy

Get sick again.....now you are on the hook for $12,000

[VanillaRhapsody]

80. Nope cost me about a grand out of pocket total...including PT

[scarystuffyo]

82. Consider your self lucky then as I said in an earlier post

[VanillaRhapsody]

83. I consider myself covered under Obamacares...

Get you some!

[VanillaRhapsody]

81. and no that is the maximum out of pocket my friend....

The maximum out-of-pocket costs for any Marketplace plan for 2015 are $6,600 for an individual plan and $13,200 for a family plan. This means when the amount you’ve paid in deductibles, copayments, and coinsurance reaches these limits, the insurance company pays 100% of your costs for covered care. Even if you choose a catastrophic coverage plan your out-of-pocket costs shouldn’t exceed this limit.

and ^^^THAT^^^ is the real beauty of this plan.

[scarystuffyo]

84. That's what I said

[VanillaRhapsody]

85. No you said I would HAVE to pay it again....

No I don't....with $10 copays...its going to be a LOOOOONG while before I reach $6000....and IF I did...it will be BECAUSE I had something MAJOR going on that year...and I will be glad that THAT only cost me $6 grand.

[scarystuffyo]

86. That's yearly not a life time limit

[VanillaRhapsody]

102. so?

Have you had any major medical lately?

[NJCher]

94. just curious, but

What was the deductible?

I tried to buy a policy but none of them made any financial sense. I would have to spend 2-3000 for the deductible before they would kick in dime one, and even after that I would have to pay the co-pays.

There was nothing about it that made any economic sense. About the only way it would is if a person had huge medical bills with chronic diseases like heart problems, diabetes, etc.

What I don't understand is why some people can get decent deals and others can't.


Cher

[VanillaRhapsody]

103. do you make more than $40,000 a year? If not you get subsidized....I WAS at 91%

[oneshooter]

87. I just got a reup notice from an ObamaCare supplier.

The payments are going from $211 a month to $455 a month with REDUCED benefits.

That is double in one year.

A LOt of savings there.

[VanillaRhapsody]

88. the Exchange hasn't opened....

go on the Exchange.

Get a subsidy.

[VanillaRhapsody]

89. besides that is up to the Insurer...not Obamacares....

shop around.

[eridani]

96. If you don't like it, do something about our Third World income inequality

The "game" for the half of the population that is poor or near poor is called "survival."

[daredtowork]

97. A huge portion of the U.S is playing that game

That's why it's galling to see people undermining the few attempts to do anything about it.

[eridani]

98. ACA has done nothing for income inequality n/t

[Boom Sound 416]

11. Great plan

Sheesh

[VanillaRhapsody]

18. another lie...

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay one of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

[Travis_0004]

24. What is a lie?

I realize there is a tax if you dont have health insurance. You can be exempt from the tax if you have a hardship. One hardship is receiving a shutoff notice from a utility. Even a millionaire could skip a payment or two and create the hardship to avoid paying a tax.

[VanillaRhapsody]

28. No your salary is counted....

sheesh....you will get caught. Dude they have your tax information.

anyone who would do that to avoid a $95 penalty that could afford it....is trash in my book.

[Travis_0004]

55. you wont get caught because you are not breaking any laws

Also the fee is small this year but increases. If somebody could avoid a 700 tax in a few years, why not avoid it? I have health insurance so I wont have to pay the tax, Im just letting people know that options exist.

[VanillaRhapsody]

75. Yes you are...if you are claiming hardship and your salary doesn't match...THAT is breaking the law.

and what YOU are doing here....is encouraging others to break the law too....You might want to consider retractions.

When you fill out this form...you are swearing that information is true...

[moriah]

90. Now you make Democrats out to sound like cheats.

If you can't pay for insurance with the subsidies and also can't pay the fee, most likely you will already qualify for a hardship exemption and may already be juggling bills around, robbing Peter to pay Paul. What do you suggest for people in all-utilities-paid units, like me, to do to deliberately cheat the system?

It sounds like advice someone would give to some young, healthy person who just doesn't want to pay their fair share, not like advice that you would give someone actually worried about how to pay it.

----

As for me, I've gotten a hell of a lot out of my healthcare than I paid into it. I've already hit my max out-of-pocket for the year, $1200, without having to even touch my deductible. I've had enough copays on doctor's visits and medicine to hit max OOP. The rest of my year's medicine and doctors visits are free. My plan this year cost $82.94 a month with the subsidy, due to the brouhaha over on another ACA thread I'm going to wait until they've finalized rates and subsidies on the 15th to confirm how much it'll be (it was different last week when I looked).

They need to fix the "loophole" that makes it where family coverage through an employer can be more than 9% of the income for a family. That would make more people eligible for truly affordable, usable health care.

Sure, I wish it cost less to get my prescription, but that's what the max OOP is for. I wish it was cheaper to see my psychiatrist. I still have to struggle until I hit max OOP. But at least I can see those doctors, get that medication, etc.

[Travis_0004]

95. I didnt write the law or the exemptions

Im only reporting what the law says. I dont really care if people without insurance pay the tax or not. Since the IRS has no enforcement powers to collect the ACA tax, you dont even really need to claim a hardship, just dont pay the tax.

[VanillaRhapsody]

104. thank goodness....but you are NOT reporting the truth. I on the other hand who has first hand

knowledge.....

Why are you on a Democratic Forum suggesting folks break the law?

[Angleae]

100. Actually they can.

As the penalty is added on your income tax return, they can charge you with either income tax evasion (if you don't pay enough) or filing a fraudulant income tax return (if you don't add the penalty to your taxes).

[magical thyme]

6. the fine will be <25% of the insurance I would be forced to buy

since I make a few dollars too much to qualify for the subsidies.

And the insurance company that my one p/t job offers is the same fuckers that left me to die when I was septic. My dentist saved my life, and I paid out of pocket to a small whole health service -- a nutritionist and a counselor -- to recover physically and emotionally.

So I'll pay the fine. I won't renege, because I don't want them to try to take it from my social security when I start collecting next year, or pulling any other dirty tricks out of their box of dirty tricks.

But Harvard Health will never get one cent out of me, period.

[VanillaRhapsody]

19. BAH LONEY!

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay one of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

[BlindTiresias]

10. Hahahaha, fuck me

Great way to coerce people into entering a market. A+ neo-liberal corporatism.

[Lex]

13. You are exempt from the penalty:

--- people whose incomes are so low they don’t have to file taxes (currently $9,500 for individuals and $19,000 for married couples);

--- and people for whom health insurance is considered unaffordable (where insurance premiums after employer contributions and federal subsidies exceed 8% of family income)

[BlindTiresias]

14. Still allows for a lot of people to get slammed

I'm sorry, it wasn't a good policy.

[Lex]

16. But not everyone is penalized

unlike what most people try to push as the truth.

[BlindTiresias]

20. Yeah, I'm aware

But the number of people who will get slammed by this is still substantial. To make matters worse this is essentially forcing people to enter a market just by existing.

[VanillaRhapsody]

21. slammed?

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay one of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.


Uh slammed you say???

[BlindTiresias]

22. Uh, did you read the OP?

It is increasing.

[VanillaRhapsody]

26. Yes and I supplied THAT information too...

earlier in the thread....for almost everyone it is going DOWN...And the top amount for those it MAY slightly increase...is NO WHERE near that amount!

AND she hasn't even applied for this year yet...

[BlindTiresias]

30. Uhh, are you actually a bot or just have poor reading comprehension?

From the site https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/

The fee in 2015

If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:

2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay one of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

The fee after 2015

The penalty increases every year. In 2016 it’s 2.5% of income or $695 per person. After that it's adjusted for inflation.



Relevant portions highlighted. The penalty is going up.

[VanillaRhapsody]

35. 2% of what?

If you are in hardship....you get exemptions or subsidies....go on the exchange..

I made over $300 a week on unemployment....I got a Good Silver Plan for $61 a month! $10 deductibles....

ANYONE who makes UNDER $40,000 a year for a single person gets a Subsidy...

Any FAMILY of 4 making UNDER $90,000 gets a Subsidy.

Anyone making around $20 an hour or less qualifies for subsidy.

[BlindTiresias]

38. Yeah

I've been on the exchange, it kind of sucks. To make matters worse in 2015 and beyond those premiums for anything not garbage (like Bronze) will cost about as much as not having insurance. As I said, it is a captive market and by design.

You did notice how much the penalties are going up, right? You did see that?

[VanillaRhapsody]

43. Oh fuck no it doesn't....I was on the Exchange and GOT the insurance

It is NOT going up for most people...stop spreading bullshit


If you make $40k a year or less...up to around $20 an hour you qualify for subsidy on the Exchange. But you can ONLY get the subsidy on the Exchange.

[BlindTiresias]

47. What the hell?

The penalty IS going up! On the books, right there on the site. What the hell is wrong with your reading comprehension?

It says right there on the site that the penalties are going up every year. I swear to God you are either obtuse beyond belief or a legit bot.

[VanillaRhapsody]

48. Not till NEXT YEAR....

get you some insurance this year and avoid it!

I Suwannee!

(and you call me obtuse? That is the fucking point....to make people get insured in the first damn place)

[BlindTiresias]

50. Yes, and as the penalties go up

People are either forced to get the insurance or pay a penalty that would cost about the same. That is the very definition of a captive market and constitutes a slamming of people who make enough to not qualify for substantial subsidies but not enough that this won't be painful. Is this now clear to you?

[VanillaRhapsody]

58. IF you don't get insurance...

Individual responsibility changes – Under the ACA, individuals are required to have health insurance or pay a tax penalty. The penalty is being phased in. For 2014, the penalty is the greater of $95 per adult or 1% of household income over the tax filing threshold; in 2015 it will increase to $325 per adult or 2% of household income over the tax filing threshold. The amount of penalty is capped at the cost of the lowest cost bronze plan, and the law exempts from the penalty people who don’t obtain coverage because it is unaffordable or for some other

[BlindTiresias]

59. Uh.. yes? I already said that.

Chatbot confirmed.

[VanillaRhapsody]

61. $325 is slamming them?

and this would be for those making OVER $40,000 a year....

[BlindTiresias]

62. Look at the rates go up

Wow it goes up to 600 something dollars eventually, hmmm... it is almost as if I said the penalties go up steadily each year.

[VanillaRhapsody]

64. the rates are NOT going up!

that is where YOU are wrong!

[BlindTiresias]

65. Sorry, penalties

The penalties are going up.

[VanillaRhapsody]

66. to $325 for those making over $40k a year......for crying out loud....

Get some fucking insurance and avoid the whole damn problem!

27 dollars a month penalty.

[BlindTiresias]

69. Then 600+ after that

So it is pay 325 dollars in 2015 (695 in 2016) or pay 300+ a month for insurance. Man, not a great choice there. It is almost as if we are being penalized by the government for not entering a market.

[VanillaRhapsody]

70. then get some Insurance...that is the fucking point!

we NEED to get more in the pool! This is how you slowly move the stragglers in that direction....don't want to pay the fine....get insured. Eventually....getting some healthcare for you money starts to look better and better. (not to mention all the freebies that are included)

WE voted...you don't get to opt out!

[BlindTiresias]

71. Right...

So people can funnel hundreds of dollars a month into private entities just for existing? Good solution, Vanilla, very progressive.

It is an individually focused solution for a large scale problem and it was designed to enrich insurance companies. You are a goddamned farce of a progressive if you love that and think it is the best we can do.

[VanillaRhapsody]

72. Yes...for their health.

we don't have other choices atm.

You want to protest by paying the fines....be my guest!

[BlindTiresias]

73. Then you are lost.

Goodnight.

[VanillaRhapsody]

76. I am not lost...I am doing JUST fine ....Thanks President Obama!

the insurance that I will not go without Health Insurance while Unemployed has changed my life!

[HockeyMom]

27. Religion is another exemption

but I think that is limited to only 2 or 3 religions. If I didn't age into free Medicare,which I don't use, I just might have joined one of these religions since my philosophical beliefs for health care are about in line with these religions.

[JCMach1]

91. OR, if you have been denied Medicaid coverage in States that did not expand under ACA

[randys1]

32. Dont want to pay a fee, DEMAND single payer

Start by supporting Bernie Sanders for president

[rug]

33. Fee?

Is that what it's being called now?

[Spacemom]

57. What happens to those who fall in the "family glitch"?

I can't find info on this. My employer offers insurance, My husbands does not. I can cover myself and our kids, but to cover my husband more than doubles my portion of the premium. We can not afford this.

Will he have to pay the penalty?

[BlindTiresias]

60. Anyone not covered gets hit with the penalty.

[Lex]

92. Not true. There are exemptions. nt

[BlindTiresias]

93. yeah

based on income and employment. Her husband is employed and makes enough that he would have to buy the insurance (presumably).

[VanillaRhapsody]

101. Right...and unless he makes more than $40,000 he will be subsidized.

[VanillaRhapsody]

105. what is this "Family Glitch"?

He can go on the exchange and get a policy that covers you all because HIS company doesn't offer it.

And families of 4 who make up to $90,000 a year are subsidized.

[Spacemom]

108. Family glitch

Because the Individual coverage offered by my employer is less than 9.5% of family income, it is considered affordable coverage. That makes him ineligible for subsidies on the exchange. No matter that adding him to the policy more than doubles the cost. Yes, he could get insurance on the exchange, but without subsides, it's just as unaffordable.

[VanillaRhapsody]

109. Oh really? Has he considered how unaffordable a major medical catastrophe will cost him..

Max out of pocket for a single person is only 6 grand. Small price to pay not to go bankrupt.

[nitpicker]

106. As I understand the current rules

Last edited Fri Nov 14, 2014, 07:30 AM - Edit history (1)

((warning, this may be rewritten AGAIN before it's time to file the return))

People are required to get their employer's self-only coverage (or pay the penalty) if it costs up to 9.5% or less of HOUSEHOLD income.
(that's a change from 8% to support "employer transition&quot .

If it costs more than that, a hardship exemption is claimable on Form 8965 ((at least on the draft version)) for unaffordable coverage.

Family members (spouse and dependent kids) of a worker who is eligible for self-only coverage are NOT allowed to sign up via Marketplace ((currently)).

If adding the spouse to the policy pushes the total cost to more than 9.5% of household income, then one can claim the exemption of "total cost is unaffordable". If not, skipping adding the spouse triggers the penalty.

[nitpicker]

107. However, HHS has a slightly different take on this

https://www.healthcare.gov/have-job-based-coverage/change-to-marketplace-plan/

It says that affordability of coverage is based on self-only rates,

It says if employer self-only coverage is affordable and provides minimum essential coverage, you CAN switch to Marketplace but won't qualify for the premium tax credit. If the self-coverage is unaffordable or doesn't provide MEC, you can go to Marketplace and if otherwise eligible get a premium tax credit.

((I WISH IRS and HHS would say the same thing!))