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2023 Premium Tax Credit Tool: An Interactive

Tool for Congressional Users



October 8,   2024

This Insight accompanies the 2023 Premium Tax Credit Tool, a Microsoft Excel file that congressional
users can download from CRS.gov. The tool was designed to assist Congress in evaluating policy
considerations in advance of the expiration of certain premium tax credit (PTC) provisions at the end of
2025. It can be used to demonstrate how changes to certain statutory parameters of the PTC would affect
credit amounts for households with varying income, family status, and geographic characteristics.


The Premium Tax Credit

Certain households without access to subsidized health insurance coverage may be eligible for the PTC if
they enroll in coverage purchased in the health insurance exchanges. The PTC was originally established
under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) and amended
under the American Rescue Plan Act of 2021 (ARPA, P.L. 117-2) and the enacted budget reconciliation
measure (P.L. 117-169) commonly referred to as the Inflation Reduction Act. Several amendments are
temporary.
The credit amount for a household generally is calculated as the difference between the Second-Lowest-
Cost Silver Plan (SLCSP) premium and the Required Premium Contribution as per the following formula:
       Premium  Tax Credit Amount  = SLCSP  Premium  - Required Premium  Contribution
SCLSP premium  refers to the premium for the second-lowest-cost silver plan in the household's local
geographic area for its family status. Required Premium Contribution refers to the amount that a premium
credit-eligible household may pay toward the plan premium.
The Required Premium Contribution is calculated by taking a percentage of the household's income. The
applicable percentage is specified in statute and varies according to household income relative to the
federal poverty level (FPL), using poverty guidelines updated by the Department of Health and Human
Services (HHS) for the previous year. Thus, for example, the 2022 HHS poverty guidelines are used for
determining the 2023 PTC.
To be eligible to receive the PTC in 2023, households must have had annual income at or above 100% of
FPL. Eligible households with annual incomes between 100% and 149% of FPL were required to pay 0%
                                                                Congressional Research Service
                                                                https://crsreports.congress.gov
                                                                                     IN12437

CRS INSIGHT
Prepared for Members and
Committees of Congress

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