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Eliminate shortcomings in calculation of the ACA premium tax credit #3194

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martinholmer opened this issue Oct 30, 2023 · 2 comments
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aca-subsidy Affordable Care Act subsidy bug Something isn't working enhancement New feature or request tax Federal and state tax policy

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@martinholmer
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The 0.513.0 version of PolicyEngine-US has the capability to compute the Affordable Care Act (ACA) premium tax credit (PTC) for a tax unit. But the current capability has a number of shortcomings that should be eliminated. Here are some of those shortcomings:

  • Not all counties are included in the four-hundred-some ACA geographical rating areas (GRA). Examples include Harris County TX (Houston) and Marion County IN (Indianapolis).

  • ACA PTC eligibility rules have not been updated to reflect recent legislation.

  • Values for the second-lowest ACA silver-plan cost (SLSPC) are not available for NY and VT in 2022 and are not available for any state in 2023.

  • The value of the ACA modified AGI to federal poverty line variable is incorrect in that it is calculated using the current-year poverty line instead of the prior-year poverty line, and hence, all the PTC amounts are incorrect.

  • The time required to compute a PTC amount is considerable because of inefficiencies in the handling of GRA and SLSPC parameter files and in the coding of ACA logic.

Eliminating these shortcomings will be done in two steps:

(1) the aca-ca branch, which implements an alternative ACA PTC capability at the federal level and for California, will be submitted as a pull request; and

(2) an aca-rest branch, which implements the alternative ACA PTC capability for the other 49 states and for DC, will be submitted as a pull request.

After taking these two steps the old ACA PTC calculation capability will still be intact and there will also be a new ACA PTC calculation capability. At that stage, we will have the option of changing the list of federal refundable credits to include the new aca_ptc variable instead of the old premium_tax_credit variable, and of removing the old ACA PTC calculation capability.

@martinholmer martinholmer added bug Something isn't working enhancement New feature or request tax Federal and state tax policy aca-subsidy Affordable Care Act subsidy labels Oct 30, 2023
@martinholmer martinholmer self-assigned this Oct 30, 2023
@chisquared
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The likely reason NY and VT are not in the SLCSP (Second Lowest Cost Silver Plan) file is that these states have community rating, where insurance premiums can only vary by family size and area. This doesn't fit well with other states, where premiums vary by age. See parameters at https://www.cms.gov/cciio/programs-and-initiatives/health-insurance-market-reforms/state-rating

@martinholmer
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@chisquared said in issue #3194:

The likely reason NY and VT are not in the SLCSP (Second Lowest Cost Silver Plan) file is that these states have community rating, where insurance premiums can only vary by family size and area. This doesn't fit well with other states, where premiums vary by age.

Yes, you are correct in that NY and VT do not have ACA premiums that vary by age, but that is not a reason to omit those states from the the ACA PTC calculations.

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aca-subsidy Affordable Care Act subsidy bug Something isn't working enhancement New feature or request tax Federal and state tax policy
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