Self-employed, over-estimated ACA income and will be below 138% FPL.

Lots of data here. Trying to help a friend figure this out.

Self-employed and estimated $50K income. Signed up for ACA through https://nystateofhealth.ny.gov/ for 2023 (in Dec 2022). Which resulted in paying ~$200 OOP with ~$150 (monthly) in ACA subsidies. And if the economy would cooperate, all would be well.

Unfortunately, this year has been crap and total 2023 income will be in the $10K – $18K range. This is significant because 138% of FPL is 18.8K.

BTW: Obviously, this is not sustainable and there will be income changes for next year, but stuck with this income for 2023.

Questions:

Is the threshold for medicaid in NY 138% FPL? Should they get off of ACA heath insurance and transition to medicaid for rest of the year? If they go to medicaid, what are the repercussions as far as the already received subsidies? Subsidies $150*7 months = $1050 – will they need to repay that at tax time? If they do nothing, ie stay on ACA health insurance, they can afford to pay $200 and receive the $150 for rest of the year. If income is below 138% FPL – what's the impact when 2023 taxes are filed? Any other general advice for this situation?

​

Note1: 138% FPL from https://www.kff.org/interactive/subsidy-calculator/

Note2: In good health, haven't filed a medical claim in a couple of years.

Edit1: fixed a math error.

submitted by /u/yukhateeee
[comments]