For people with incomes from just above the Medicaid eligibility line through much of the middle class (400 percent of the federal poverty level), the government provides substantial help in paying monthly premiums in the form of refundable tax credits. The payments go directly to the insurers every month and are partly based on the cost of a “benchmark” plan, which is a plan in each region of the country in the silver — or second-lowest — tier of ACA coverage. More than 9 million people received a total of $32.8 billion in tax credits for 2016.
As premiums in the marketplaces have become more expensive, some ACA supporters are calling for the government to cushion the effect on consumers. Trump and some other Republicans would prefer to give people tax deductions to buy coverage, with the credits’ size depending on people’s age. Even before a GOP plan exists, the parties have begun fighting over how much the government should help and how much a potential decrease in insurance requirements would affect premium rates.