The Biden Administration today eliminated the “family glitch” from the Affordable Care Act, a flaw that makes health insurance coverage unaffordable for roughly 5 million people — more than half of them children.

“We are very pleased that this Administration continues to expand health insurance coverage for our nation’s 72 million children. Removing the family glitch will provide health care for nearly 3 million children previously shut out. We are glad to see that the push for this critical fix has succeeded. The next task will be to make similar progress on issues including offering continuous coverage to age 6 to children in Medicaid and making the Children’s Health Insurance Program permanent.”

Elaine Dalpiaz, First Focus on Children Vice President for Health Systems

The so-called “family glitch” underestimated the true cost of covering a family, making employer-sponsored health coverage unaffordable by excluding the family from marketplace subsidies.

The Administration’s final rule, to be published Thursday, Oct 13, bases eligibility for ACA health insurance subsidies for job-sponsored coverage on the cost of covering the employee and the employee’s family members. The rule also requires employer-sponsored plans to provide a minimum level of coverage — covering at least 60% of the total costs to the employee and substantial levels of inpatient hospitalization and physician services – to qualify for the program. The rule is scheduled to take effect 60 days after publication.

First Focus on Children submitted comments to the Internal Revenue Service supporting these changes. For an overview of the issues, please see our fact sheet, “Removing the Family Glitch from the ACA.”

First Focus on Children has worked for more than a decade to repair the family glitch. In 2012, First Focus Campaign for Children sent a letter to Congressional Leadership and then-President Obama urging them to remedy the family glitch, either through legislation or administrative action. In 2014, Mr. Lesley testified before a Capitol Hill health care committee, urging Congress to fix this flaw, which has negatively impacted the health coverage or affordability of coverage for an estimated 2.8 million children.