2022 ACA Affordability Percentage
The 2022 ACA Affordability Percentage is 9.61%.
Effective 2022-01-01Source: Rev. Proc. 2021-36 (IRS)Verified 2026-09-03
Required contribution percentageSource: Publication 974 (2022), Premium Tax Credit (PTC) (IRS)Verified 2026-09-03
Compared with 2021
| Item | 2021 | 2022 | Change |
|---|---|---|---|
| Required contribution percentage | 9.83% | 9.61% | -0.22% (-2.2%) |
Who it applies to
Individuals determining whether employer-sponsored minimum essential coverage is affordable under the Affordable Care Act for plan years beginning in calendar year 2022.
What changed this year, and why
For plan years beginning in calendar year 2022, the ACA Required Contribution Percentage is 9.61%, as set by IRS Revenue Procedure 2021-36. This percentage determines whether employer-sponsored health coverage is affordable for purposes of the premium tax credit under IRC § 36B.
Common questions
- What is the Required Contribution Percentage used for?
- It is used under IRC § 36B to determine whether employer-sponsored minimum essential coverage is considered affordable. If an employee's required contribution for self-only coverage exceeds 9.61% of household income, the coverage is not affordable and the employee may qualify for a premium tax credit.
- How is this percentage adjusted each year?
- It is published annually by the IRS based on premium growth relative to income growth, as determined by the Department of Health and Human Services.
Every amount on this page is a published figure rather than yours. The Affordable employer coverage calculator takes the number you enter and works it out against them, showing which published figure it used.
The share of household income that makes an offer affordable
An employer plan is generally considered affordable if the employee's share of the annual cost for self-only coverage - called the "employee required contribution" - is no more than 9.61% of the tax family's household income for 2022. The calculation uses self-only coverage even when the employee would actually enroll in family coverage because of a spouse or dependents. If the required contribution exceeds that 9.61% threshold, the offer of coverage is not affordable and the employee (and possibly family members) may be eligible for the premium tax credit on a qualified health plan purchased through the Marketplace. However, if the employee gave accurate information about employer coverage to the Marketplace and the Marketplace still allowed advance premium tax credit (APTC) on a qualified health plan, the employer coverage is treated as not affordable regardless of the dollar math. That safe-harbor rule prevents an employer from later claiming the coverage was affordable when the Marketplace has already determined otherwise based on the information provided at enrollment.
Your em- ployer coverage is generally considered affordable for you and for a family member if your share of the annual cost for self-only coverage, which is sometimes referred to as the “employee required contribution,” is not more than 9.61% of your tax family’s household income for 2022.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
An affordable offer blocks the premium tax credit
An employer-sponsored health plan must satisfy two separate tests before it can block a person from claiming the premium tax credit on Marketplace coverage: it must be affordable and it must provide minimum value. If the employer plan fails either test, the individual is not considered eligible for the employer plan for premium-tax-credit purposes and may be able to receive a credit for a qualified health plan. However, if an employee (or a family member) actually enrolls in the employer plan, that person cannot get the premium tax credit for the plan year - even if the coverage is not affordable or does not provide minimum value. The two conditions work together to determine whether the offer of coverage counts as accessible, eligible employer-sponsored coverage that prevents someone from claiming a tax credit.
Even if you had the opportunity to enroll in coverage offered by your em- ployer that qualifies as MEC, you are considered eligible for an employer-sponsored plan (and cannot get the PTC for your coverage in a qualified health plan) only if the em- ployer-sponsored coverage is affordable (defined later) and the coverage provides minimum value (defined later).
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
The second test an employer plan has to fail
An employer-sponsored health plan must provide minimum value to block a person from claiming the premium tax credit on Marketplace coverage. A plan provides minimum value only if it pays at least 60% of the total allowed costs of benefits for a standard population and provides substantial coverage of inpatient hospitalization services and physician services. If a plan fails this test - meaning it covers less than 60% of allowed costs - the individual is not considered eligible for employer coverage and may qualify for a premium tax credit on a qualified health plan purchased through the Marketplace, even if the plan would otherwise be considered affordable under the 9.61% threshold test.
How to determine if a plan provides minimum value. An employer-sponsored plan provides minimum value only if the plan pays at least 60% of the total allowed costs of benefits for a standard population and provides sub- stantial coverage of inpatient hospitalization services and physician services.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
A waiting period is not coverage you can use
An individual is not considered eligible for employer-sponsored health coverage during a month when benefits cannot be received under the plan - for example, during a waiting period before the employer coverage becomes effective. During such a month, the individual can get the premium tax credit for coverage in a qualified health plan if otherwise eligible. However, if the individual could have enrolled in employer coverage that is minimum essential coverage, affordable, and provides minimum value but did not enroll during an enrollment period, the individual cannot get the premium tax credit for the remainder of the plan year to which the enrollment period related.
You are not considered eligible for employer coverage, and can get the PTC for your coverage in a qualified health plan if you are otherwise eligible, for a month when you cannot receive benefits under the em- ployer coverage (for example, you are in a waiting period before the employer coverage becomes effective).
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
Which plans are eligible employer-sponsored coverage
Eligible employer-sponsored plans include group health insurance plans offered in the group market, self-insured group health plans for employees, coverage under certain expatriate health plans for employees, and the Nonappropriated Fund Health Benefits Program of the Department of Defense. These plans may also include retiree or COBRA coverage. Plans that are minimum essential coverage are also referred to as "eligible employer-sponsored plans." Exceptions exist for coverage that is limited to excepted benefits, such as stand-alone vision or dental plans, workers' compensation coverage, or coverage limited to a specified disease or illness - such coverage is not minimum essential coverage and therefore does not count as eligible employer-sponsored coverage for premium tax credit purposes.
Employer-sponsored plans that are MEC are also refer- red to as “eligible employer-sponsored plans.”
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
COBRA or retiree coverage from a former employer only counts against you while you are enrolled in it
Under the Premium Tax Credit rules, if your employment ends and your former employer offers you continued coverage such as COBRA or retiree coverage, that offer does not count against your eligibility for the Premium Tax Credit unless you actually enroll in it. You are considered eligible for the former employer's coverage only for the months you are enrolled. The same rule applies to someone who may enroll in the coverage because of a relationship to a former employee. This means that if you decline COBRA or retiree coverage after leaving a job, you are not treated as having an offer of affordable employer coverage for Premium Tax Credit purposes during those months.
Coverage after employment ends. If your employ- ment with an employer ends and you are offered employer coverage by your former employer (for example, COBRA or retiree coverage), you are considered eligible for that employer coverage for PTC purposes only for the months that you are enrolled in the employer coverage. This same rule applies to an individual who may enroll in the cover- age by reason of a relationship to a former employee.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
Affordability is judged on your income estimate at enrollment, not what your return later shows
When you enroll in a qualified health plan, the Marketplace determines whether your employer coverage is affordable based on its estimate of your household income at that time. If the Marketplace estimates that your required contribution for employer coverage will exceed 9.61% of your projected household income, it considers your employer coverage unaffordable and determines you are eligible for advance premium tax credits. This affordability determination is locked in at enrollment. Even if your actual household income on your tax return turns out to be higher, making your employer contribution 9.61% or less of your actual income, you can still claim the Premium Tax Credit. However, this protection does not apply if you failed to update your income and employer contribution information during annual re-enrollment periods, or if you provided incorrect information to the Marketplace with intentional or reckless disregard for the facts.
Determining affordability at the time of enrollment. Your employer coverage is not considered affordable if, when you enroll in a qualified health plan, the Marketplace determines that your required contribution for employer coverage will be more than 9.61% of what the Market- place estimates will be your household income and there- fore that you are eligible for APTC for coverage in the qualified health plan. Eligibility for employer coverage in this situation does not disqualify you from taking the PTC when you file your tax return, even if your required contri- bution for coverage was not more than 9.61% of the household income on your return.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
There is no line for the percentage itself - it enters your return as a multiplier on a worksheet
The required contribution percentage never appears as its own line on Form 8962 or anywhere else on your return. If you were offered a QSEHRA instead of employer coverage, the percentage only shows up inside Worksheet N, Worksheet To Determine if the QSEHRA Is Considered Affordable: an amount from your return is multiplied by this year's rate, 9.61%, written as a decimal, and that result is compared against the QSEHRA's permitted benefit to decide whether the arrangement counted as affordable. There is no box labeled with the percentage itself anywhere on the form - it exists only inside this worksheet's arithmetic, which is why searching the form directly for it finds nothing.
Worksheet N. Worksheet To Determine if the QSEHRA Is Considered Affordable Keep for Your Records
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
Give the Marketplace bad numbers on purpose or carelessly, and the safe harbor does not protect you
The affordability safe harbor that protects you when the Marketplace's income estimate differs from your actual tax return income does not apply if you provided incorrect information to the Marketplace about your required contribution with intentional or reckless disregard for the facts. You provide information with intentional disregard for the facts if you know that the information provided is inaccurate. This means that if you give the Marketplace bad numbers on purpose or carelessly, the safe harbor that would normally let you keep premium tax credits based on the Marketplace's estimate at enrollment does not protect you.
You provided incorrect information to the Marketplace about your required contribution with intentional or reckless disregard for the facts. You provide information with intentional disregard for the facts if you know that the information provided is inac- curate. You provide information with a reckless disregard for the facts if you make little or no effort to determine whether the information provided is accurate and your lack of effort to provide accurate information is substan- tially different from what a reasonable person would do under the circumstances.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
How each figure was verified
Each number below was read from a stored copy of the document named beside it, and checked to occur word for word in the quoted sentence. The digest is of that stored text.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
- Required contribution percentage
Your employer coverage is not considered affordable if, when you enroll in a qualified health plan, the Marketplace determines that your required contribution for employer coverage will be more than 9.61% of what the Market- place estimates will be your household income and there- fore that you are eligible for APTC for coverage in the qualified health plan.