AMA praises effort to fix ‘family glitch’ in Affordable Care Act

The American Medical Association (AMA) praised efforts to fix the “family glitch” in the federal Affordable Care Act that affects families seeking health insurance through their jobs or the ACA health insurance marketplace.

President Joe Biden’s administration announced a rule change to help hundreds of thousands of families save hundreds of dollars a month on health insurance, according to the White House.

The “family glitch” deals with costs for individual and family health insurance coverage and affects an estimated 5.1 million people, according to a 2021 estimate by the Kaiser Family Foundation. With the rule change, an estimated 200,000 uninsured people would gain coverage and almost 1 million people would see their coverage become more affordable, according to the White House.

The Biden Administration “has taken a crucial step in the campaign to cover the 5 million people who fall into the family glitch,” AMA President Gerald E. Harmon, MD, said in a news release. “The family glitch is inconsistent with the goals of the Affordable Care Act and unfairly penalizes family members of lower-income workers. The American Medical Association has repeatedly asked Congress and administrations to fix the glitch, and the Biden Administration has made good on its promise to make health care coverage more affordable.”

The AMA has called for action to fix the “family glitch” in the ACA, whereby families of workers remain ineligible for subsidized ACA marketplace coverage even though they face unaffordable premiums for coverage through employers. The goal is to allow more families of workers facing unaffordable employer coverage to access subsidies to purchase ACA marketplace coverage, the physicians association has said.

The family glitch has significant consequences for insurance, health, and finances of affected families of workers, especially those with lower incomes, AMA Executive Vice President James L. Madara, MD, has said.

A family “that falls into the glitch” may remain insured, but could face serious budgetary repercussions in doing so based on health insurance costs, Madara said in a letter to the federal Centers for Medicare & Medicaid Services.

AMA Immediate Past President Susan R. Bailey, MD, called it “commonsense reform” that “will open the door to affordable ACA marketplace coverage for many families now experiencing extreme difficulties in affording their employer coverage, or who are uninsured.”