A taxpayer has received a $7,200 Obamacare subsidy in 2020. During the year, they ended up with medical expenses of $25,000 that they would like to itemize. They would also would like to roll some pretax 401(k) funds to a Roth IRA. This would create a situation where income is now higher than planned for, and some of the Obamacare subsidy needs to be repaid. The higher income level created for the rollover would also reduce the amount of the medical expenses that could be itemized.
My question: can the payback of the Obamacare subsidy be used to offset how much of the itemized deduction is reduced by?