Question: I plug-in earnings of $45,000 for the year. Age 46, in Los Angeles county region 16 (zip 90036). Covered California calculator says I am not eligible for a subsidy. The note says: “For your income, age, and location, the cost of health insurance is below the “fair share” amount called for under the Affordable Care Act. This means you will pay less for coverage than people living in areas with higher insurance costs or people who have higher costs due to their age.” Do you know what “fair share” is and if indeed this “fair share” also affects my subsidy eligibility?
Answer: The ACA considers your “fair share” to be anything less than 9.5% of your income. This converts to $356/mo. for an income of $45,000. The premiums for a Silver Level plan in the scenario you provided are below $356/mo., so even though your income is less than 400% FPL, there is no subsidy available because the premiums are low enough for your fair share.