I misspoke...now that I clarified with the client, his W-2, Box 1 includes the NET premiums paid (Column A - Column C).  And the remaining $4,000+ was for a supplemental policy.  So...back to the original question...can the $4,100 repayment be deducted as SE health?  The total ACTUAL paid by the client was $14K+ and now they also have to repay the $4,100 APTC on top of that.