Health insurance can be confusing—especially when you’re trying to make sure your entire family is covered. In the past, many families found themselves in a frustrating situation known as the “family glitch.” But now, thanks to a recent fix, there are new opportunities for spouses and dependents to access more affordable coverage.

If you’re shopping for health insurance for your family, here’s what you need to know.

What Was the “Family Glitch”?

The “family glitch” was a flaw in how the Affordable Care Act (ACA) was originally interpreted. Under the old rules, if one person in a household had access to an affordable employer-sponsored health plan—even if it only covered that person—their entire family was considered ineligible for subsidies through the ACA Marketplace.

Here’s why that was a problem:

• The affordability test was based only on the cost of self-only coverage, not family coverage.
• Many families couldn’t afford the employer’s family plan, but they also didn’t qualify for help buying a Marketplace plan.

This left many families caught in the middle—paying too much or going without coverage.

What Changed with the Family Glitch Fix?

In 2023, the federal government issued a rule to fix the glitch.

Now:

• Affordability is calculated separately for the employee and their family.
• If the cost of family coverage through the employer is too high (more than 8.39% of household income in 2024), the spouse and dependents may qualify for Marketplace subsidies—even if the employee is enrolled in their job-based plan.

This fix opens the door for families to explore better coverage options that may be more affordable.

What Does This Mean for You?

If you have employer coverage and you’re trying to insure your spouse or kids, here’s what to do:

1. Check the Cost of Family Coverage

Look at the premium your employer charges for covering your spouse and/or dependents. If that amount is considered unaffordable based on your household income, your family might now qualify for financial help through the ACA Marketplace.

2. Run the Numbers

Use the Marketplace’s affordability tools or talk to a licensed agent at Oasis Insurance Group to see if your family qualifies for subsidies. Many families are finding they can now get high-quality plans at a much lower cost than before.

3. Consider a Split-Coverage Approach

In some cases, it might make sense for the employee to stay on their employer’s plan, while the rest of the family enrolls in a Marketplace plan using subsidies.

This approach can offer major savings while still ensuring everyone has coverage.

4. Contact Oasis Insurance Group

If all of this information is making your head swirl, let our health insurance experts help you get the best coverage for your family.

Frequently Asked Questions

Q: Can the employee drop their employer plan and go to the Marketplace too?
Yes—but unless their coverage is also considered unaffordable, they likely won’t qualify for subsidies. Check with an advisor before making changes.

Q: Does this impact Medicaid eligibility?
No. Medicaid is based on income and household size. This change affects families who don’t qualify for Medicaid but still need help affording private insurance.

Q: Can Oasis Insurance Group help with this?
Absolutely! We specialize in helping families understand their options and find the most affordable, effective coverage available. Contact us today!

The Bottom Line

The family glitch fix is a game-changer for many households. If you’ve struggled with high premiums to cover your spouse or kids, it’s time to take another look. You may now qualify for help that wasn’t available before.

Need help reviewing your family’s options?

Our licensed agents at Oasis Insurance Group are here to make the process simple and stress-free. Contact us today to get answers, compare plans, and enroll—all at no extra cost.