Quick Answer: In 2026, you qualify for ACA marketplace subsidies if your household income falls between 100% and 400% of the federal poverty level (FPL), you are not enrolled in Medicare or Medicaid, and you do not have affordable coverage through an employer. For a single person, that means income between $15,650 and $62,600. For a family of four, between $32,150 and $128,600.
As of 2026, the Affordable Care Act marketplace remains the primary source of subsidized health coverage for Americans who do not get insurance through a job, Medicaid, or Medicare. More than 23 million people are currently enrolled. Whether you are self-employed, between jobs, or simply cannot afford full-price premiums, the ACA marketplace may cover a significant portion of your monthly costs.
This guide explains exactly who qualifies, how much help is available, and how to apply.
Who Qualifies for ACA Marketplace Coverage in 2026?
To enroll in an ACA marketplace plan and receive premium tax credits, you must meet all of the following requirements:
- Live in the United States and intend to be present for the coverage year
- Be a U.S. citizen, U.S. national, or lawfully present immigrant
- Not be incarcerated (other than pending disposition of charges)
- Not be enrolled in Medicare or otherwise eligible for it
- Not be eligible for Medicaid or CHIP based on your income and state
- Not have access to affordable employer-sponsored coverage (affordable is defined as costing more than 9.02% of your household income for self-only coverage in 2026)
- Have income between 100% and 400% FPL (in Medicaid expansion states, the floor is 138% FPL because lower incomes route to Medicaid)
If you are undocumented, you cannot enroll in a marketplace plan or receive subsidies. However, children and pregnant individuals may qualify for Medicaid or CHIP in many states regardless of immigration status.
ACA Subsidy Income Limits for 2026
For 2026 coverage, subsidy eligibility is based on the 2025 federal poverty guidelines. The table below shows key income thresholds by household size.
| Household Size | 100% FPL | 138% FPL (Medicaid line) | 150% FPL | 200% FPL | 250% FPL | 400% FPL (subsidy cliff) |
|---|
| 1 person | $15,650 | $21,597 | $23,475 | $31,300 | $39,125 | $62,600 |
| 2 people | $21,150 | $29,187 | $31,725 | $42,300 | $52,875 | $84,600 |
| 3 people | $26,650 | $36,777 | $39,975 | $53,300 | $66,625 | $106,600 |
| 4 people | $32,150 | $44,367 | $48,225 | $64,300 | $80,375 | $128,600 |
| 5 people | $37,650 | $51,957 | $56,475 | $75,300 | $94,125 | $150,600 |
| 6 people | $43,150 | $59,547 | $64,725 | $86,300 | $107,875 | $172,600 |
Important 2026 change: The enhanced subsidies that were in place from 2021 through 2025 expired at the end of 2025. As a result, the 400% FPL subsidy cliff has returned. If your income exceeds 400% FPL, you do not qualify for premium tax credits in 2026. This is a meaningful change from last year, when people with incomes above 400% FPL could still receive some help.
Alaska and Hawaii use higher FPL numbers, which means higher income limits to qualify.
Three Types of Financial Help Available
1. Premium Tax Credits (PTCs)
Premium tax credits reduce your monthly insurance premium. They are available to households with income between 100% and 400% FPL who meet the other eligibility requirements above. The credit amount is calculated on a sliding scale: the lower your income relative to FPL, the larger your credit. Households at 100% to 150% FPL often qualify for plans with $0 or very low monthly premiums.
You can take the credit in advance (it is paid directly to your insurer each month, reducing your bill) or claim it when you file your federal taxes.
2. Cost-Sharing Reductions (CSRs)
Cost-sharing reductions lower your out-of-pocket costs, including deductibles, copays, and the annual out-of-pocket maximum. To receive CSRs in 2026, you must:
- Have income between 100% and 250% FPL
- Enroll in a Silver-tier plan on the marketplace (not Bronze, Gold, or Platinum)
CSRs are not available off-exchange. If you buy directly from an insurer, you will not receive CSRs even if you qualify. The benefit varies by income:
| Income Level | Silver Plan Out-of-Pocket Max (Single) | Silver Plan Out-of-Pocket Max (Family) |
|---|
| 100% to 150% FPL | Up to $1,200 | Up to $2,400 |
| 150% to 200% FPL | Up to $3,400 | Up to $6,800 |
| 200% to 250% FPL | Up to $8,450 | Up to $16,900 |
| Above 250% FPL | Standard cap (no CSR) | Standard cap (no CSR) |
If you are in the 100% to 200% FPL range, enrolling in Silver is almost always better than Bronze, even if the Bronze premium looks cheaper on paper.
3. Medicaid (for Lower Incomes)
If your income falls below 138% FPL and you live in a Medicaid expansion state, you will likely be directed to Medicaid rather than the marketplace. Medicaid has no monthly premiums and minimal out-of-pocket costs. As of 2026, 40 states plus Washington D.C. have expanded Medicaid.
In non-expansion states, people with income below 100% FPL fall into a coverage gap: they earn too little for marketplace subsidies but do not qualify for Medicaid under their state's rules. If you live in a non-expansion state and your income is very low, check directly with your state Medicaid office.
Check your eligibility at CoveredUSA's screener to find out whether you qualify for Medicaid or marketplace coverage in your state.
ACA Metal Tiers: Which Plan Level Should You Choose?
ACA plans come in four metal tiers. The tier determines how costs are split between you and the insurer, not the quality of care.
| Plan Tier | Average Share Paid by Insurer | Good For |
|---|
| Bronze | 60% | Healthy people who rarely use care |
| Silver | 70% | Most people, especially those under 250% FPL (CSR boost) |
| Gold | 80% | People who expect regular medical visits or prescriptions |
| Platinum | 90% | High-utilization; highest premiums |
If you qualify for cost-sharing reductions (income under 250% FPL), a Silver plan can function like a Gold or Platinum plan at a fraction of the cost. This is one of the most overlooked advantages in the ACA system.
When Can You Enroll in 2026?
Open Enrollment
ACA open enrollment for the 2026 plan year ran from November 1, 2025 through January 15, 2026. If you enrolled by December 15, your coverage started January 1. Enrollments completed between December 16 and January 15 had a February 1 start date.
Open enrollment for the 2027 plan year begins November 1, 2026.
Special Enrollment Periods
If you missed open enrollment, you may still qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event. An SEP typically gives you 60 days from the event to enroll. Common qualifying events include:
- Loss of coverage: Job loss, aging off a parent's plan (turning 26), losing Medicaid or CHIP
- Household changes: Marriage, divorce, birth or adoption of a child
- Moving: Changing your permanent address to a new coverage area, moving from abroad, or moving from a Medicaid-only area
- Income change: A change in income that makes you newly eligible for marketplace coverage or subsidies
- Release from incarceration
Loss of Medicaid triggers a 90-day SEP in most states.
Medicaid and CHIP Year-Round Enrollment
Medicaid and CHIP have no open enrollment window. You can apply at any time. If your income drops or your household situation changes, apply immediately.
How to Calculate Your Income for ACA Purposes
ACA subsidies are based on your Modified Adjusted Gross Income (MAGI), not your gross paycheck. MAGI includes:
- Wages and salaries
- Self-employment income (after business deductions)
- Freelance and gig income
- Unemployment compensation
- Social Security benefits (if you file taxes)
- Rental income
- Interest and dividends
MAGI does not include child support received, gifts, or worker's compensation payments.
Use your best estimate for the year. If your income changes during the year, update your marketplace application to avoid owing money or missing out on additional credits.
Step-by-Step: How to Apply for ACA Coverage
Step 1: Check your eligibility. Use the CoveredUSA screener to find out which programs you may qualify for. It takes about 2 minutes and is available in Spanish.
Step 2: Gather your information. You will need your Social Security number (or immigrant documentation), household size, estimated annual income, and employer information if you have a job.
Step 3: Create an account on HealthCare.gov (or your state marketplace if you live in a state with its own exchange). States with their own marketplaces include California, New York, Texas (uses federal), and others.
Step 4: Complete the application. Enter your household details and income. The marketplace will determine your eligibility for premium tax credits, CSRs, Medicaid, or CHIP.
Step 5: Compare plans. Filter by metal tier, monthly premium, deductible, and whether your doctors and prescriptions are in-network. Do not choose a plan based on premium alone.
Step 6: Enroll. Confirm your plan selection. Your first premium payment activates coverage.
Step 7: File Form 8962 with your taxes. At tax time, you reconcile your advance premium tax credits with your actual income. If you earned more than estimated, you may owe some back. If less, you may receive a refund.
You can also work with a free, licensed navigator or broker instead of doing this alone. CoveredUSA connects you with licensed agents at no cost.
States With Their Own Marketplaces
These states run their own exchanges rather than using HealthCare.gov:
California (Covered California), Colorado, Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, Washington, and Washington D.C.
If you live in one of these states, apply through your state marketplace, not HealthCare.gov. The rules and deadlines may differ slightly.
For income limit details used in subsidy calculations, see our ACA income limits reference page.
What Changed in 2026 vs. Previous Years
The biggest change in 2026 is the expiration of the Inflation Reduction Act's enhanced premium subsidies, which were in place from 2022 through 2025. Those provisions:
- Eliminated the 400% FPL subsidy cliff (anyone could get help regardless of income)
- Capped premiums at no more than 8.5% of income for all enrollees
Both provisions expired. As of 2026:
- Subsidies are only available up to 400% FPL
- People earning above 400% FPL pay full unsubsidized premiums
- Lower-income households (100% to 400% FPL) still receive credits, but the amounts are somewhat less generous than under the enhanced rules
If you received subsidies in 2025 and your income is near or above 400% FPL, check your eligibility again. Your situation may have changed.
Check your eligibility now at CoveredUSA, it takes 2 minutes.
Frequently Asked Questions
What income qualifies for ACA subsidies in 2026?
As of 2026, you qualify for premium tax credits if your household income is between 100% and 400% of the federal poverty level. For a single person, that is $15,650 to $62,600. For a family of four, that is $32,150 to $128,600. The enhanced subsidies that extended eligibility above 400% FPL expired at the end of 2025.
Can I get ACA coverage if I am self-employed or a freelancer?
Yes. Self-employment income counts toward your MAGI, and you can enroll in a marketplace plan. Many self-employed people qualify for subsidies because business deductions reduce their reportable income. You are also exempt from needing employer coverage, which is one of the disqualifying factors for subsidies.
What if I have a job but my employer plan is too expensive?
If your employer's cheapest self-only plan costs more than 9.02% of your household income in 2026, it is considered unaffordable and you may qualify for marketplace subsidies. However, the affordability test uses self-only coverage, not family coverage. If you have a family, this can create a gap where the employer plan is deemed affordable (for you alone) but the family coverage is not, and your dependents may qualify for marketplace plans while you do not.
Does the ACA cover immigrants?
Lawfully present immigrants can enroll in marketplace plans and qualify for subsidies based on income. This includes green card holders, refugees, asylees, DACA recipients (depending on state), and others with certain visa types. Undocumented immigrants cannot use the marketplace. Some states have expanded Medicaid to undocumented adults and children using state funds.
What is the difference between a premium tax credit and a cost-sharing reduction?
A premium tax credit reduces your monthly insurance bill. It is applied to any metal tier plan and can be taken in advance or at tax time. A cost-sharing reduction lowers your deductible, copay, and out-of-pocket maximum, but it is only available on Silver plans purchased through the marketplace. If you qualify for CSRs (income below 250% FPL), choosing Silver is almost always the right move.
Can I enroll outside of open enrollment?
Only if you have a qualifying life event. Common triggers include losing other coverage, getting married, having a baby, or moving to a new coverage area. Most qualifying events give you a 60-day window to enroll. Losing Medicaid triggers a 90-day window in most states. If you have no qualifying event and missed open enrollment, you will need to wait until November 1 when the next open enrollment begins.
How do I know if my state expanded Medicaid?
As of 2026, 40 states plus Washington D.C. have expanded Medicaid under the ACA. Non-expansion states include Texas, Florida, Georgia, Tennessee, and a few others. If your income is below 138% FPL and you live in an expansion state, you should apply for Medicaid rather than a marketplace plan. Use the CoveredUSA screener to get a fast answer for your state.
What happens if my income changes during the year?
Report income changes to your marketplace as soon as they happen. If you end up earning more than you estimated, you may have to repay some advance credits when you file taxes. If you earn less, you may qualify for a larger credit or transition to Medicaid. Updating your application mid-year minimizes reconciliation surprises at tax time.
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