The short answer: if you live in one of 20 states (plus Washington D.C.) that run their own exchange, you apply on your state's platform, not HealthCare.gov. Residents of the other 28 states go directly to HealthCare.gov. Either way, the same ACA plans and federal subsidies are available, but state-run exchanges can offer extra benefits and different enrollment deadlines that HealthCare.gov cannot.
Quick Answer: HealthCare.gov is the federally run ACA marketplace serving 28 states. State-based marketplaces (SBMs) are separate platforms operated by 20 states and D.C. Your ZIP code determines which platform to use. The plans, income rules, and federal subsidies work identically on both; only the website, customer service, and potential state-specific extras differ.
As of 2026, more than 23.1 million Americans enrolled in ACA marketplace coverage, according to CMS enrollment data. Knowing which platform applies to your state can save you time and potentially hundreds of dollars per year in state-specific subsidies.
What Is HealthCare.gov?
HealthCare.gov is the federally facilitated marketplace (FFM) run by the Centers for Medicare and Medicaid Services (CMS). It handles plan shopping, subsidy calculation, and enrollment for residents of states that chose not to build their own exchange.
For 2026, HealthCare.gov covers residents of these 28 states:
Alabama, Alaska, Arizona, Delaware, Florida, Hawaii, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.
Two additional states, Arkansas and Oregon, have "state-based marketplaces on the federal platform" (SBM-FP). They operate their own Navigator programs and oversight, but residents still enroll through HealthCare.gov. Oregon plans to move to its own fully state-run platform for 2027 coverage.
What Is a State-Based Marketplace?
A state-based marketplace (SBM) is an ACA exchange that a state built and operates independently. The website, customer service, and enrollment process are all managed at the state level.
For 2026, these 20 states plus D.C. run their own platforms:
| State | Marketplace Name |
|---|
| California | Covered California |
| Colorado | Connect for Health Colorado |
| Connecticut | Access Health CT |
| Georgia | Georgia Access |
| Idaho | Your Health Idaho |
| Illinois | GetCoveredIllinois (new for 2026) |
| Kentucky | kynect |
| Maine | CoverME.gov |
| Maryland | Maryland Health Connection |
| Massachusetts | Massachusetts Health Connector |
| Minnesota | MNsure |
| Nevada | Nevada Health Link |
| New Jersey | Get Covered NJ |
| New Mexico | beWellnm |
| New York | NY State of Health |
| Pennsylvania | Pennie |
| Rhode Island | HealthSource RI |
| Vermont | Vermont Health Connect |
| Virginia | Marketplace Virginia |
| Washington | Washington Healthplanfinder |
| Washington D.C. | DC Health Link |
Illinois joined this list in November 2025, making it the most recent state to launch a fully independent exchange.
Key Differences: HealthCare.gov vs State Marketplace
The underlying ACA rules (what plans must cover, how premiums are calculated, federal premium tax credits) are identical on both platforms. What differs is the wrapper around them.
| Feature | HealthCare.gov (FFM) | State-Based Marketplace (SBM) |
|---|
| Operates in | 28 states | 20 states + D.C. |
| Who runs it | Federal government (CMS) | State government |
| Federal subsidies available | Yes | Yes |
| State-specific extra subsidies | No | Some states offer additional help |
| Open enrollment end date | Jan 15, 2026 (for 2026 coverage) | Varies by state (some extend to Jan 31 or later) |
| Customer service | Federal call center | State call center |
| Website | HealthCare.gov | State-specific URL |
| Special enrollment periods | Federal SEP rules | States can add state-specific SEPs |
| Plan selection interface | Standardized across all FFM states | State-designed, varies by state |
The Subsidy Advantage in Some States
This is where state-based marketplaces can create a meaningful financial difference for some households. As of 2026, the enhanced federal subsidies that ran from 2021 to 2025 have lapsed, bringing back the "subsidy cliff" at 400% of the federal poverty level (FPL). If your income exceeds 400% FPL, federal subsidies are now zero.
However, 10 states layer on their own additional subsidies: California, Colorado, Connecticut, Maryland, Massachusetts, New Jersey, New Mexico, New York, Vermont, and Washington. All 10 of these states operate their own marketplace platforms.
Massachusetts is investing an extra $250 million into its ConnectorCare program for 2026, keeping premiums stable for roughly 270,000 residents despite the lapsed federal credits. California's Covered California extends state subsidies to households up to 600% FPL, well above the federal 400% cap.
If you live in one of these 10 states, enrolling through the correct state platform is the only way to access both the federal and state subsidies stacked together.
2026 ACA Income Eligibility Table
Federal subsidies are available based on your household income relative to the federal poverty level (FPL). The 2026 marketplace uses 2025 FPL guidelines, as published by ASPE (HHS).
2026 ACA Subsidy Income Limits, Continental U.S.
| Household Size | 100% FPL (Medicaid floor) | 400% FPL (Federal subsidy cap) |
|---|
| 1 | $15,650 | $62,600 |
| 2 | $21,150 | $84,600 |
| 3 | $26,650 | $106,600 |
| 4 | $32,150 | $128,600 |
| 5 | $37,650 | $150,600 |
| 6 | $43,150 | $172,600 |
| 7 | $48,650 | $194,600 |
| 8 | $54,150 | $216,600 |
| Each additional person | + $5,500 | + $22,000 |
Source: 2025 Federal Poverty Guidelines, ASPE.HHS.gov. Alaska and Hawaii have higher thresholds.
If your income falls between 100% and 400% FPL, you qualify for federal premium tax credits on either HealthCare.gov or a state marketplace. In Medicaid expansion states, if your income is below 138% FPL, you typically qualify for Medicaid instead of a marketplace plan. The screener at CoveredUSA determines which program fits.
Cost-sharing reductions (CSRs), which lower your deductibles and copays, are available only on Silver plans for households earning between 100% and 250% FPL, regardless of which marketplace you use. See the KFF subsidy explainer for more detail.
How to Apply: Step-by-Step
2026 Open Enrollment is closed (the window ran November 1, 2025 to January 15, 2026 for HealthCare.gov states). You can still enroll through a Special Enrollment Period (SEP) if you have a qualifying life event. Open enrollment for 2027 coverage begins November 1, 2026.
Documents you will need:
- Social Security numbers for everyone applying
- Most recent tax return or income documents (pay stubs, 1099s)
- Current health insurance card (if you have one)
- Employer coverage details (policy ID, employer name) if applicable
- Immigration documents (if applicable)
- Bank account information if paying premiums by direct draft
Step 1: Confirm your state's platform.
Go to HealthCare.gov and enter your ZIP code. If your state runs its own exchange, HealthCare.gov will redirect you to the correct state site automatically.
Step 2: Create an account.
Set up an account on the correct platform (HealthCare.gov or your state's site). Use the same email you'll use for plan documents.
Step 3: Complete the application.
Enter household information: number of people, ages, income for the year, and current coverage status. The application runs an income check to see whether you qualify for Medicaid, CHIP, or marketplace subsidies.
Step 4: Compare plans.
Review available plans by metal tier (Bronze, Silver, Gold, Platinum). If you qualify for CSRs, Silver plans offer the best value. The platform shows your estimated monthly premium after the tax credit.
Step 5: Select a plan and enroll.
Pick a plan and complete enrollment. Pay your first premium directly to the insurer to activate coverage.
Step 6: Watch for confirmation.
You will receive an enrollment confirmation from the marketplace and a separate welcome packet from the insurer.
Common reasons applications get denied or delayed:
- Income entered does not match IRS records (use annual household income, not just your own)
- Household size mismatch between application and tax filing
- Employer coverage deemed "affordable" under ACA rules (blocks subsidy eligibility)
- Immigration status documentation incomplete
- Missing Social Security numbers for dependents
Check your eligibility now at CoveredUSA. It takes 2 minutes. Use the free screener at /screener to find out whether you qualify for Medicaid, a subsidized marketplace plan, or other programs before you go through the full application.
Which Platform Should You Use?
The decision is determined by your state, not your preference. Here is the quick checklist:
- Look up your state above. If it appears in the SBM table, you apply on that state's website.
- If your state is not in the SBM table, go to HealthCare.gov.
- If you are in one of the 10 states with extra subsidies, make sure you apply through the state platform so the state credits are applied on top of any federal credits.
- If you are in Arkansas or Oregon, you are technically in an SBM but still use HealthCare.gov to enroll. Just be aware your state has its own navigator program if you need help.
The plans themselves are standardized under federal ACA rules, so you will not find "better" plans on one platform over the other in most cases. What changes is whether your state adds financial help that HealthCare.gov cannot provide.
Frequently Asked Questions
Does it matter if I use HealthCare.gov vs my state's marketplace?
Yes, if your state runs its own marketplace, you must use that platform to access all available subsidies, including any state-funded credits on top of federal ones. If you live in a HealthCare.gov state, that is your only option and all eligible federal subsidies are available there.
What if I accidentally apply on the wrong platform?
If you use HealthCare.gov and your state has its own exchange, the site will typically redirect you automatically. If you complete an application in the wrong place, contact your state marketplace to see if the enrollment can be transferred or if you need to reapply.
Can I get subsidies if my income is above 400% FPL in 2026?
At the federal level, no. The enhanced subsidies that covered people above 400% FPL lapsed after 2025. However, if you live in California, Colorado, Connecticut, Maryland, Massachusetts, New Jersey, New Mexico, New York, Vermont, or Washington, your state may provide additional credits that extend past the federal 400% cap. Check your state marketplace directly for current income limits.
When is open enrollment for 2027 ACA coverage?
Open enrollment for 2027 coverage begins November 1, 2026. HealthCare.gov states will likely have an end date around January 15, 2027. State-based marketplaces may run longer, with some extended to January 31 in past years. Outside of open enrollment, you need a qualifying life event (job loss, marriage, birth, move) to enroll through a Special Enrollment Period.
Are the same insurance companies available on both platforms?
Insurers choose which marketplaces to participate in by state. You may find the same carrier on both a state platform and HealthCare.gov, but the specific plans and networks can vary. Always compare plans on the marketplace that applies to your state, not a different state's platform.
Do I apply for Medicaid on the marketplace website?
In most states, yes. When you fill out a marketplace application, the system checks whether your income qualifies for Medicaid and routes you there if so. In some states, Medicaid applications go through a separate state agency portal. The eligibility screener at CoveredUSA checks both at once and tells you which program fits your situation.
Is a broker or navigator required?
No. You can apply directly on HealthCare.gov or your state's marketplace without any help. Free assisters (Navigators) are available in every state if you want in-person or phone help. Licensed insurance brokers can also help at no additional cost to you; they are paid by the insurance company.
What is a Special Enrollment Period (SEP) and do I qualify?
An SEP lets you enroll outside open enrollment if you have a qualifying life event. Common qualifying events include losing job-based coverage, getting married or divorced, having a baby or adopting a child, moving to a new ZIP code or county, or losing Medicaid eligibility. You generally have 60 days from the event to enroll. Some state marketplaces recognize additional qualifying events beyond the federal list.
