State marketplace enrollment fell; officials warn about subsidy cliff for some immigrants and high earners

Kentucky Department for Medicaid Services staff reported that the state-based marketplace closed open enrollment with 89,028 enrollees and a notable shift in plan shopping patterns.

Senior deputy commissioner Veronica Judy Cecil said the state saw about a 30% decrease in new enrollees compared with the prior year but an 80% increase in existing enrollees shopping and changing plans. She reported double-digit percentage decreases in gold and silver enrollments and increases in bronze and catastrophic tiers.

A colleague identified only as David provided additional context on subsidy impacts. He said the federal rules limit certain immigrant eligibility for tax subsidies (those subject to the five‑year bar), and warned that people above 400% of the federal poverty level are not eligible for premium tax credits. "If people say their income is something now, get to the end of the year and their income is above that 400%, to put in perspective what that is, that would be 82,500 or something for an individual," David said, and cautioned such households could owe subsidies back if they exceed thresholds at year end.

David said the department is working with affected people and noted limited IRS year‑end adjustments for some incomes, but stressed there is "no absolute grace for people above 400%." The department urged anyone with questions about marketplace eligibility or subsidies to contact the relevant assistance channels.