Quick Answer: The enhanced ACA premium tax credits expired on January 1, 2026. Millions of people saw their premiums jump or lost subsidies entirely. You may still qualify for standard premium tax credits (income 100 to 400% FPL), Medicaid, CHIP, or a plan change through a Special Enrollment Period. Use the free screener at CoveredUSA to find out which programs you qualify for in under 2 minutes.
If your health insurance bill jumped at the start of 2026, you are not alone. The enhanced premium tax credits that reduced marketplace premiums by an average of $536 per year expired on December 31, 2025. For many households, that means premiums nearly doubled overnight. According to analysis from KFF, average marketplace premium payments more than doubled, a roughly 114% increase, when the enhanced credits lapsed.
This article explains what changed, who still qualifies for ACA subsidies in 2026, and the concrete steps you can take right now to lower your costs or find alternative coverage.
What Changed for ACA Subsidies in 2026
From 2021 through 2025, the American Rescue Plan Act and the Inflation Reduction Act expanded ACA premium tax credits in two key ways. First, they increased subsidy amounts across all income levels. Second, they removed the 400% FPL income cap, meaning households earning above that threshold could still receive some subsidy.
Both of those expansions expired at the end of 2025.
As of 2026, the ACA subsidy rules have reverted to pre-2021 rules:
- Income cap is back at 400% FPL. If your household income is even one dollar above the 400% threshold, you receive zero premium tax credit. This is sometimes called the "subsidy cliff."
- Required contributions are higher. A household earning 200% FPL must now contribute about 6.6% of income toward the benchmark Silver plan premium, up from about 2% in 2025.
- No repayment cap. If you received advance premium tax credits in 2026 and your income ends up higher than projected, you must repay the full difference on your tax return. There is no repayment cap for tax years after 2025.
Who Still Qualifies for ACA Premium Tax Credits in 2026
Standard premium tax credits are still available in 2026. The key requirement is that your household income falls between 100% and 400% of the 2025 federal poverty level (FPL) and you are not eligible for other qualifying coverage like Medicaid, Medicare, or an affordable employer plan.
The table below shows the income range for subsidy eligibility by household size for 2026 (based on 2025 FPL figures):
| Household Size | 100% FPL (minimum) | 400% FPL (maximum) |
|---|
| 1 person | $15,650 | $62,600 |
| 2 people | $21,150 | $84,600 |
| 3 people | $26,650 | $106,600 |
| 4 people | $32,150 | $128,600 |
| 5 people | $37,650 | $150,600 |
| 6 people | $43,150 | $172,600 |
| 7 people | $48,650 | $194,600 |
| 8 people | $54,150 | $216,600 |
If your income is in this range, you still qualify for some level of subsidy in 2026. The amount decreases as income rises toward 400% FPL. At 100% to 133% FPL, your required contribution toward the benchmark Silver plan is only about 2.1% of income. At 350% to 400% FPL, that required contribution rises to around 9.75%.
You can also qualify for cost-sharing reductions (CSRs) if your income is between 100% and 250% FPL and you enroll in a Silver plan. CSRs lower your deductible, copays, and out-of-pocket maximum, making your coverage significantly more useful even if the monthly premium subsidy is modest.
Check your current eligibility at CoveredUSA's eligibility screener to get a personalized result based on your income and household size.
What To Do Right Now: Step-by-Step
Step 1: Figure Out Why You Lost the Subsidy
The first step is understanding exactly what happened. There are three common reasons people lose ACA subsidies:
- Income went above 400% FPL. With the subsidy cliff restored in 2026, even a small raise or additional income can eliminate your entire subsidy.
- Enhanced credits expired. Your income and plan did not change, but the extra subsidy from 2021 to 2025 simply expired.
- Life change was not reported. If your household size, income, or coverage situation changed and you did not update your marketplace application, your subsidy may have been recalculated.
Log in to your HealthCare.gov or state marketplace account and review your current application. If your income or household information is stale, update it immediately.
Step 2: Check If You Now Qualify for Medicaid
If your income dropped or is lower than you expected, you may qualify for Medicaid instead of marketplace coverage. In the 41 states that have expanded Medicaid (plus DC), adults with income at or below 138% FPL qualify for Medicaid. That is $21,597 for a single person or $44,367 for a family of four (based on 2025 FPL, which is what ACA marketplace eligibility uses for 2026).
Medicaid has no monthly premium in most states and very low cost-sharing. If you qualify, it is almost always better than a marketplace plan.
In the remaining states that have not expanded Medicaid (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming), adults without children generally do not qualify for Medicaid unless they meet specific disability or income criteria. If you are in one of these states and your income is below 100% FPL, you may fall into a coverage gap with limited options.
Step 3: Explore a Plan Change Through a Special Enrollment Period
If you currently have a marketplace plan but can no longer afford it due to the premium increase, you may be able to change plans using a Special Enrollment Period (SEP). Standard qualifying events include:
- Loss of other qualifying coverage (job-based insurance, Medicaid, CHIP)
- Marriage, divorce, or legal separation
- Birth or adoption of a child
- Permanent move to a new coverage area
- Turning 26 and aging off a parent's plan
You generally have 60 days from the qualifying event to enroll in a new plan. If you lost Medicaid coverage, the window extends to 90 days.
An income change alone does not typically trigger a SEP for an existing marketplace enrollee. However, if you were not enrolled at all and have a qualifying event, you can use the SEP to enroll now.
Step 4: Consider Lowering Your MAGI to Recapture Subsidies
Your premium tax credit is based on your Modified Adjusted Gross Income (MAGI), not your gross pay. If you are near the 400% FPL cutoff or lost subsidies because your income was just above the threshold, you can sometimes reduce MAGI through legitimate strategies:
- Pre-tax 401(k) or IRA contributions. Each dollar contributed to a traditional 401(k) reduces MAGI by a dollar. For 2026, the 401(k) limit is $23,500 for those under 50.
- Health Savings Account (HSA) contributions. If you are enrolled in a high-deductible health plan, HSA contributions reduce MAGI. The 2026 HSA limit is $4,300 for individual coverage and $8,550 for family coverage.
- Flexible Spending Account (FSA) contributions through an employer also reduce MAGI.
This approach is most useful for households that are just over the income limit. If your income is well above 400% FPL, the math may not work.
Step 5: Check for State-Specific Assistance Programs
A handful of states have created their own programs to fill the gap left by the expired federal enhanced credits. As of 2026:
- California operates Covered California with its own state premium assistance for moderate-income enrollees.
- New Mexico passed legislation to fully backfill the lost enhanced credits for 2026 enrollees.
- Colorado, Maryland, and Washington also have state-funded supplemental programs that may reduce your net premium beyond the federal subsidy.
If you live in one of these states, check your state marketplace website directly for current program details, or use the CoveredUSA screener to see what you qualify for.
Step 6: Do Not Go Without Coverage
If you drop your marketplace plan because you can no longer afford it, you are uninsured. One hospital visit can result in a bill of tens of thousands of dollars. Before letting your plan lapse:
- See if you qualify for a lower-cost Silver plan with cost-sharing reductions at CoveredUSA's eligibility screener
- Check if a Bronze plan or catastrophic plan (available to people under 30 or with a hardship exemption) fits your budget
- Check Medicaid eligibility, especially if your income dropped recently
- Explore CHIP if you have children at home
Check your eligibility now at CoveredUSA, it takes 2 minutes.
Income Table: What You Might Owe for a Benchmark Silver Plan in 2026
The table below shows the required contribution percentage toward the second-lowest-cost Silver plan (SLCSP) by income level as of 2026. Your subsidy covers the rest of the plan's premium.
| Income as % of FPL | Required Contribution (% of income) |
|---|
| 100% to 133% | 2.10% |
| 133% to 150% | 3.45% to 4.75% |
| 150% to 200% | 4.75% to 6.60% |
| 200% to 250% | 6.60% to 8.35% |
| 250% to 300% | 8.35% to 9.75% |
| 300% to 400% | 9.75% |
| Above 400% | Full premium (no subsidy) |
The subsidy covers whatever the benchmark Silver plan costs above your required contribution. If you choose a cheaper Bronze plan, the subsidy still applies and your net premium may be very low or even zero.
What If Your Subsidy Was Higher Last Year and Dropped?
Many households are noticing the difference between their 2025 plan cost and their 2026 plan cost for the same coverage. In 2025, the enhanced credits were still in effect, so the required contribution percentages were lower and anyone earning up to just under the applicable amount above 400% FPL could still receive some subsidy.
In 2026, if your income is at 300% FPL, you pay roughly 9.75% of income toward the benchmark plan. In 2025, that same household paid a smaller required contribution percentage, meaning the federal government covered more of the premium.
If the premium change is significant enough that you cannot afford to stay enrolled, explore whether a Bronze plan or HSA-compatible high-deductible plan reduces your monthly cost enough to stay covered. A lower-premium plan with higher out-of-pocket costs is better than no coverage.
Frequently Asked Questions
Who qualifies for ACA premium tax credits in 2026?
As of 2026, you qualify if your household income is between 100% and 400% of the federal poverty level, you are not eligible for Medicaid or Medicare, and you are not offered affordable employer coverage. The income cap of 400% FPL was restored when the enhanced credits expired at the end of 2025.
What happens if I already received advance credits and my income was too high?
If you received advance premium tax credits throughout 2026 and your actual income was higher than you projected, you must repay the excess when you file your 2026 federal taxes. As of 2026, there is no repayment cap, so the full overpayment is owed. To avoid a large tax bill, update your income estimate on your marketplace application as soon as your income changes.
Can I still get ACA coverage even if I missed open enrollment?
Yes, if you have a qualifying life event. The most common qualifying events are loss of other coverage, marriage, divorce, birth or adoption of a child, and a permanent move. You generally have 60 days from the event to enroll. Without a qualifying event, you must wait for the next Open Enrollment Period, which typically runs from November 1 through January 15.
I live in a state that hasn't expanded Medicaid and my income is below 100% FPL. What are my options?
If you are in a non-expansion state and your income falls below 100% FPL, you likely fall into the Medicaid coverage gap. You may not qualify for marketplace subsidies (which require income of at least 100% FPL) or Medicaid. Options include community health centers that use a sliding-fee scale, state or county indigent care programs, and federally qualified health centers (FQHCs). Prescription drug manufacturers also have patient assistance programs for uninsured people.
Does losing ACA subsidies count as a qualifying event for a Special Enrollment Period?
No. A change in subsidy amount or the expiration of enhanced credits does not trigger a Special Enrollment Period. However, if your premium increase makes coverage unaffordable and you drop your plan, losing that coverage could trigger a SEP to re-enroll. The safest approach is to check your eligibility and find an affordable plan before dropping coverage entirely.
How do cost-sharing reductions work in 2026?
Cost-sharing reductions (CSRs) are available to Silver plan enrollees with income between 100% and 250% FPL. They lower your deductible, copays, and out-of-pocket maximum. To receive CSRs, you must specifically enroll in a Silver plan. Bronze and Gold plans do not include CSRs even if you qualify based on income. If your income is between 100% and 250% FPL, a Silver plan with CSRs often provides the best overall value even if the monthly premium is slightly higher than a Bronze plan.
What states have their own supplemental premium assistance in 2026?
As of 2026, California (Covered California), New Mexico, Colorado, Maryland, and Washington have state-funded programs that provide additional premium assistance beyond the federal subsidy. Eligibility and benefit amounts vary. Check your state marketplace for current details.
Can reducing my income help me recapture my ACA subsidy?
It depends on how far above the threshold you are. Pre-tax retirement contributions (traditional 401(k), IRA), HSA contributions, and FSA contributions all reduce your MAGI, which is what the subsidy calculation uses. If you are within a few thousand dollars of the 400% FPL cutoff, this approach can restore some or all of your subsidy. If you are significantly over the limit, the math likely will not work out.
