Question: If an employer offers “affordable” coverage for the employee, but the family cannot afford the dependent coverage and the family income is below the Medi-Cal eligibility threshold, is the family still eligible for Medi-Cal? Is the employee disqualified from Medi-Cal by the “affordable” employer plan? If so, are the wife and kids eligible for Medi-Cal?
Answer: Under the ACA, qualification for Medi-Cal is completely separate from subsidy-eligibility rules. Employees, will not be disqualified from Medi-Cal if their employer provides benefits, whether or not those benefits meet affordability guidelines. (This answer was provided by expert agent, Anne Kelley.)