The problem stems from different and very liberal qualification levels for children. In this area, a typical family of four has to have a Modified Adjusted Gross Income (MAGI) of over $62,643 before the kids are allowed onto a regular insurance plan. For the adults to qualify, the MAGI has to be below $32,499. There are an awful lot of families sitting between the thresholds.
As far as I know, the only way around it is to go outside the exchange, forgo the Advance Premium Tax Credit (a.k.a. the revokable subsidy) and pay full freight for separate policies for the children. I'm not sure, though, if having a mixture of policies inside a family - Exchange plans for the adults and Off-Exchange plans for the kids - impacts APTC eligibility for the adults. Any other suggestions?
Household Size | MAGI Medi-Cal Threshold |
MAGI Medi-Cal/CHIP Threshold |
138% Fed Poverty Lvl | 266% Fed Poverty Lvl | |
1 | $15,856 | $30,563 |
2 | $21,403 | $41,256 |
3 | $26,951 | $51,949 |
4 | $32,499 | $62,643 |
5 | $38.406 | $73,336 |
6 | $43,594 | $84,029 |
7 | $49,141 | $94,722 |
8 | $54,689 | $105,415 |
Each Additional | $5,547 | $10,693 |