As of 2026, the ACA premium tax credit is back to its pre-pandemic rules. The enhanced subsidies that ran from 2021 through 2025 have expired, which means the 400% Federal Poverty Level income cap is back in effect. If your household income falls between 100% and 400% FPL, you may qualify for a premium tax credit that reduces your monthly health insurance cost. This guide walks through how the calculation works, what the income limits are for 2026, and how to get an accurate estimate for your situation.
What Is the ACA Premium Tax Credit?
The premium tax credit (PTC) is a federal subsidy that lowers the monthly premium you pay for a health plan through the ACA Marketplace. You can take it in advance as a monthly reduction on your bill (called an Advance Premium Tax Credit, or APTC), or claim it when you file your taxes. Most people take it upfront so they pay less each month.
The credit is calculated based on three things:
- Your household income as a percentage of the Federal Poverty Level (FPL)
- The cost of the second-lowest-cost Silver plan (called the benchmark plan or SLCSP) in your area
- The percentage of income you are expected to contribute toward health coverage
Your subsidy equals the benchmark plan cost minus your expected contribution. If the benchmark Silver plan in your county costs $500 per month and your expected contribution is $150, your credit is $350 per month.
2026 ACA Income Limits by Household Size
Eligibility for 2026 Marketplace subsidies is based on the 2025 Federal Poverty Level guidelines. You must earn at least 100% FPL to qualify (unless you live in a non-expansion Medicaid state and fall in the coverage gap, which has its own rules). The upper limit is 400% FPL.
| Household Size | 100% FPL | 150% FPL | 200% FPL | 250% FPL | 400% FPL |
|---|
| 1 person | $15,650 | $23,475 | $31,300 | $39,125 | $62,600 |
| 2 people | $21,150 | $31,725 | $42,300 | $52,875 | $84,600 |
| 3 people | $26,650 | $39,975 | $53,300 | $66,625 | $106,600 |
| 4 people | $32,150 | $48,225 | $64,300 | $80,375 | $128,600 |
| 5 people | $37,650 | $56,475 | $75,300 | $94,125 | $150,600 |
| 6 people | $43,150 | $64,725 | $86,300 | $107,875 | $172,600 |
If your income is above 400% FPL even by one dollar, you receive no premium tax credit under the 2026 rules. This is the "subsidy cliff" that returned when the enhanced subsidies expired.
The 250% FPL threshold matters for a separate benefit: cost-sharing reductions (CSRs). If you earn up to 250% FPL and enroll in a Silver plan, you can get significantly lower deductibles, copays, and out-of-pocket maximums on top of the premium credit. CSRs were not part of the enhanced subsidy legislation, so they remain available in 2026 the same way they always have.
How the Premium Tax Credit Formula Works
The IRS sets a sliding scale of what percentage of your income you are expected to contribute toward health coverage. The lower your income relative to FPL, the smaller the percentage. The credit makes up the gap between your expected contribution and the actual benchmark plan cost.
Here is how the calculation works step by step.
Step 1: Find your income as a percentage of FPL.
Divide your expected annual household income by the FPL threshold for your household size. For example, a single person earning $31,300 is at exactly 200% FPL.
Step 2: Identify your expected contribution percentage.
Under 2026 rules, the contribution percentages are higher than they were from 2021 to 2025. A household at 150% FPL is expected to contribute about 3% to 4% of income. At 200% FPL, the expected contribution is roughly 6% to 6.5%. At 300% FPL, it rises toward 9% to 9.5%. At 400% FPL, households are expected to contribute around 9.78% of income, which was the pre-enhanced-subsidy cap.
Step 3: Calculate your expected monthly contribution.
Multiply your annual income by the applicable percentage and divide by 12.
Step 4: Subtract from the benchmark Silver plan premium.
Find the second-lowest-cost Silver plan available to your household in your ZIP code. Your monthly credit equals that benchmark premium minus your expected monthly contribution. If your expected contribution is higher than the benchmark plan cost, your credit is zero.
Step 5: Apply the credit to any metal tier.
You can apply the credit toward any Bronze, Silver, Gold, or Platinum plan. If you apply it toward a Bronze plan that costs less than the benchmark Silver, you may end up paying very little or nothing per month. If you choose a more expensive Gold plan, you pay the difference.
What Changed in 2026 vs. 2025
The biggest change is the return of the 400% FPL income cliff. Under the American Rescue Plan Act (2021) and Inflation Reduction Act (2022), enhanced subsidies were available to households at any income level, and those above 400% FPL could receive credits for the first time. That provision expired on December 31, 2025.
Key differences in 2026:
- Households above 400% FPL no longer qualify for any premium tax credit
- The required contribution percentages increased at all income levels
- An estimated 7 to 8 million people who had subsidies under the enhanced rules will either lose their credit entirely or see a significant reduction
- Average premium increases for affected households are estimated at over $1,000 per year
If you were receiving subsidies in 2025 and your income is above 400% FPL, you should revisit your plan options during open enrollment to understand your new cost.
Cost-Sharing Reductions Still Available in 2026
Cost-sharing reductions (CSRs) are a separate benefit from the premium tax credit, and they remain available in 2026. CSRs only apply to Silver plans, and they reduce your actual cost when you use care, not just your monthly premium.
| Income Level | What CSR Does |
|---|
| 100% to 150% FPL | Reduces actuarial value to ~94% (deductibles and out-of-pocket costs are very low) |
| 150% to 200% FPL | Reduces actuarial value to ~87% |
| 200% to 250% FPL | Reduces actuarial value to ~73% |
| Above 250% FPL | No CSR benefit |
If you qualify for CSRs, enrolling in a Silver plan is almost always the better financial choice even if a Bronze plan has a lower monthly premium, because your actual out-of-pocket costs will be dramatically lower.
How to Estimate Your 2026 Subsidy
The most accurate way to estimate your subsidy is to use HealthCare.gov's built-in calculator, which pulls real plan data and actual benchmark premiums for your specific county. The KFF Health Insurance Marketplace Calculator is another widely trusted free tool.
To get a useful estimate, you will need:
- Your ZIP code (plan costs vary significantly by county)
- Household size (everyone who files taxes together)
- Expected 2026 household income (your best estimate of Modified Adjusted Gross Income, or MAGI)
- Ages of all household members being covered
- Whether you or anyone in your household has access to affordable job-based coverage
Your MAGI includes wages, self-employment income, Social Security benefits, capital gains, and most other income. It does not include things like child support received or workers compensation.
Who Does Not Qualify for Marketplace Subsidies
Even if your income falls within the 100% to 400% FPL range, you may not qualify if:
- You have access to job-based health insurance that meets the ACA's affordability standard. In 2026, employer coverage is considered affordable if the employee-only premium costs less than 9.02% of household income.
- You are eligible for Medicaid or CHIP based on your income and state
- You are enrolled in Medicare
- You are listed as a dependent on someone else's tax return
If you are disqualified by job-based coverage only because the self-only premium is affordable but family coverage is too expensive, the "family glitch" fix from 2022 may still help some members of your household qualify.
How to Apply for the Premium Tax Credit
If you qualify, here are the steps to get your credit.
Step 1: Check your eligibility.
Start with a quick eligibility screen before you spend time comparing plans. Check your eligibility at CoveredUSA in under 2 minutes.
Step 2: Gather your income information.
Estimate your 2026 MAGI. If your income varies (self-employment, gig work, seasonal), use your best guess. You will reconcile the actual amount when you file your 2026 tax return.
Step 3: Go to HealthCare.gov or your state exchange.
Most states use the federal exchange at HealthCare.gov. Some states run their own exchanges (California uses Covered California, New York uses NY State of Health, etc.). The enrollment process and subsidy calculation work the same way.
Step 4: Create or log into your account.
If you had coverage in 2025, log into your existing account. Your information from last year will be pre-populated but you should review it for accuracy.
Step 5: Compare plans and confirm your credit.
The exchange will show you your estimated monthly credit automatically once you enter your household details. You will see net premium costs after credit for each available plan.
Step 6: Enroll and confirm your APTC election.
Choose whether to take the credit monthly (APTC) or wait until tax time. Most people take it monthly. Confirm your plan selection before the enrollment deadline.
Step 7: Report income changes during the year.
If your income changes significantly, update your Marketplace account so your APTC stays accurate. Receiving too much APTC means you repay the difference when you file taxes. Receiving too little means you get the remainder back as a refund.
Open enrollment for 2026 coverage ran from November 1, 2025 through January 15, 2026 in most states. Outside open enrollment, you can only enroll if you qualify for a Special Enrollment Period triggered by events like losing other coverage, getting married, having a baby, or moving.
Check your eligibility now at CoveredUSA, it takes 2 minutes.
You can also review the full ACA income limits for 2026 on CoveredUSA for a detailed reference table.
Frequently Asked Questions
What income range qualifies for ACA subsidies in 2026?
For 2026, you qualify for the premium tax credit if your household income is between 100% and 400% of the Federal Poverty Level. For a single person, that is roughly $15,650 to $62,600. For a family of four, it is roughly $32,150 to $128,600. The exact limits depend on household size and are based on the 2025 FPL guidelines.
How do I use an ACA subsidy calculator for 2026?
Enter your ZIP code, household size, ages of household members, and estimated 2026 income into a subsidy calculator. The calculator finds the benchmark Silver plan cost in your area, applies the IRS contribution percentage for your income level, and shows your estimated monthly credit. HealthCare.gov and KFF both offer free calculators.
Did ACA subsidies change in 2026?
Yes. The enhanced subsidies that expanded eligibility above 400% FPL and reduced required contributions at all income levels expired at the end of 2025. In 2026, the subsidy cliff is back at 400% FPL, and households at the same income levels will generally pay more toward their premiums than they did in 2025.
Can I still get subsidies if I am self-employed in 2026?
Yes. Self-employed individuals who purchase their own coverage through the Marketplace can qualify for the premium tax credit based on their net self-employment income. Your MAGI for subsidy purposes includes your net profit after deducting business expenses and the self-employment tax deduction. If your income varies significantly from year to year, you can update your estimated income on HealthCare.gov during the year to keep your APTC accurate.
What happens if I estimated my income wrong?
Your subsidy is reconciled when you file your federal tax return using Form 8962. If you received more APTC than you were entitled to (because your actual income was higher than estimated), you repay the excess up to an annual cap. If you received less than you were entitled to (income came in lower than expected), you receive the difference as a tax credit.
What is the benchmark plan used in the subsidy calculation?
The benchmark plan is the second-lowest-cost Silver plan available to your household in your county. It is also called the SLCSP (Second Lowest Cost Silver Plan). You do not have to enroll in that specific plan. The benchmark just determines the size of your credit, which you can then apply to any qualified health plan on the exchange.
Do cost-sharing reductions still exist in 2026?
Yes. Cost-sharing reductions reduce your deductibles, copays, and out-of-pocket maximum on Silver plans if your income is between 100% and 250% FPL. CSRs were not part of the enhanced subsidy legislation and remain available in 2026 exactly as before. To get CSRs, you must enroll in a Silver plan.
How does the ACA subsidy interact with Medicaid?
If your income is below 138% FPL and you live in a Medicaid expansion state, you will likely qualify for Medicaid rather than Marketplace subsidies. Medicaid covers a broader range of services with minimal or no cost sharing. If you live in a non-expansion state and your income is below 100% FPL, you may fall in the coverage gap with no subsidy options. CoveredUSA's screener checks both Medicaid and Marketplace eligibility at the same time.
