Millions passing up Affordable Care Act subsidies

If you' re unfortunate enough to have lost companysponsored health insurance as well as your job amid the economic havoc caused by COVID, you've probably been shocked by the cost of private coverage. Monthly premiums for high-deductible plans can run $1,500 to $3,000 — bad enough in good times but devastating when you're unemployed.

Some 29 million Americans went without health insurance in 2019, largely because coverage costs so much. And the Kaiser Family Foundation says the total has almost certainly grown since then.

Millions of those people do not have to risk being uninsured in a pandemic. More than four out of 10 uninsured people could obtain no- or low-cost coverage under the Affordable Care Act, or Obamacare, the Kaiser Foundation's Program on the ACA says.

“Unfortunately, a large share of the population is unaware the A CA offers financial assistance to buy insurance ,” says Cynthia

Cox, director of Programs on the ACA. The assistance is in the form of tax credits, which reduce monthly premiums.

Some people think they have too much home equity or too much savings to qualify. “They don't realize qualification is based solely on income, not assets,” says Emily Gee, a health economist at the Center for American Progress.

Here is a quick primer on what is available, whether you are eligible, and how you can apply.

The ACA established marketplaces where insurers offer a variety of plans that meet minimum-coverage standards. Some states run their own marketplaces while the rest rely on the federal health insurance marketplace. There are four levels of coverage: platinum, gold, silver and bronze. Platinum plans have the highest premium sand lowest deductibles; bronze plans have low premiums and high deductibles.

As an example, bronze plans for families in New York City cost about $1,400 a month, but come with a $4,700 out-ofpocket deductible. Platinum

plans are as high as $5,370 a month, but there is no deductible.

About 10 million people are eligible for help, Kaiser estimates. Half would qualify for enough aid to cover all t he premiums on bronze plans. You still have to pay the deductible, but you'd be on the

hook for that without insurance, too.

The value of a no-premium bronze-level plan becomes clear if COVID19 or an accident puts you in a hospital, where a three-day stay costs $30,000, on average. Comprehensive cancer care can cost 10 times as much or far more.

Five million other currently uninsured people maybe eligible for a credit t hat covers 50%

to 90% or more of their premiums. The idea is to cap how much of t heir income individuals and families pay for covera ge. Families at the poverty line —$26,200 for a household of four in 2020 — pay no more than 2.06% of their income on premiums, and a tax credit pays the rest. As incomes rise, so does the percentage of income that participants are required to contribute.