2026 is the first plan year since 2020 where the original ACA subsidy structure applies. The enhanced premium tax credits (PTCs) that covered millions of additional Americans from 2021 through 2025 expired on December 31, 2025. That means the 400% federal poverty level (FPL) hard cutoff is back, contribution percentages are higher, and roughly 4 to 5 million people who received subsidies in 2025 no longer qualify in 2026.
This guide covers exactly who qualifies in 2026, what your income limit is by household size, how premium tax credits and cost-sharing reductions are calculated, and what changed versus 2025. If your income is too low for ACA subsidies, you may qualify for Medicaid instead.
What Changed in 2026: The Subsidy Cliff Returns
From 2021 through 2025, the American Rescue Plan Act and Inflation Reduction Act eliminated the 400% FPL subsidy cliff and capped premium contributions at 0% for people below 150% FPL and 8.5% for everyone above. Those laws expired December 31, 2025.
In 2026, the original ACA structure applies. You must earn at least 100% FPL to qualify for any premium tax credit. You must earn no more than 400% FPL. Above that, you pay full price. This comparison shows what it means for a single person at different income levels:
Premium contribution cap comparison: 2025 (enhanced) vs. 2026 (original ACA)| Income Level | % of FPL (1 person) | Max premium % of income (2025) | Max premium % of income (2026) |
|---|
| Below $23,475 | Below 150% FPL | 0% | 2.10%-4.19% |
| $23,475 to $31,300 | 150%-200% FPL | Up to 2% | 4.19%-6.60% |
| $31,300 to $46,950 | 200%-300% FPL | Up to 4%-6% | 6.60%-9.96% |
| $46,950 to $62,600 | 300%-400% FPL | Up to 8.5% | 9.96% |
| Above $62,600 | Above 400% FPL | 8.5% (subsidized) | No subsidy (full price) |
FPL figures based on a household of 1. 2026 contribution percentages are the original ACA rates indexed for inflation. Source: CMS 2026 PAPI Parameters Guidance; IRS Rev. Proc. 2025-25.
Source: CMS, IRS Rev. Proc. 2025-25
Cost-Sharing Reductions: The Silver Plan Bonus
Cost-sharing reductions (CSRs) are a second layer of savings that lower your deductible, copays, and out-of-pocket maximum, but only if you pick a Silver plan. CSRs survived the 2026 reversion and still apply to Silver plan enrollees earning 100-250% FPL.
The three CSR tiers in 2026 work as follows:
- 100-150% FPL: Silver plan enhanced to approximately 94% actuarial value. You pay roughly 6% of total costs out of pocket.
- 150-200% FPL: Silver plan enhanced to approximately 87% actuarial value. You pay roughly 13% of total costs out of pocket.
- 200-250% FPL: Silver plan enhanced to approximately 73% actuarial value. You pay roughly 27% of total costs out of pocket.
- Above 250% FPL: No CSR benefit. All metal tiers (Bronze, Silver, Gold, Platinum) qualify only for premium tax credits, not CSRs.
The Coverage Gap: Below 100% FPL in Non-Expansion States
If your income falls below 100% FPL and you live in one of the 10 states that have not expanded Medicaid (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming), you fall into the coverage gap. You earn too little for marketplace subsidies (which start at 100% FPL) and too much for traditional Medicaid in your state. You are not eligible for premium tax credits.
If you live in one of the 40 states plus DC that have expanded Medicaid under the ACA, Medicaid covers individuals up to 138% FPL (approximately $21,597 for a single person in 2026). In those states, the floor for marketplace subsidies meets the Medicaid ceiling at 138% FPL, so there is no gap.
Special Enrollment Periods in 2026
The 2026 open enrollment period (OEP) for plan year 2026 coverage ran November 1, 2025 to January 15, 2026. That window is closed. To enroll or change plans after January 15, you need a qualifying life event that triggers a special enrollment period. SEPs typically give you 60 days from the qualifying event.
Note: the year-round SEP for people earning below 150% FPL has been eliminated for 2026 under the One Big Beautiful Bill Act and CMS's 2025 Marketplace Integrity Rule. The next open enrollment period for 2027 coverage runs November 1, 2026 to January 15, 2027.
- Loss of other coverage (job-based insurance, Medicaid, CHIP, COBRA expiration)
- Marriage or entering a domestic partnership
- Birth, adoption, or foster placement of a child
- Permanent move to a new coverage area (even within the same state)
- Divorce or legal separation causing loss of coverage
- Gaining citizenship or lawful immigration status
Premium Tax Credit Calculation: How the Subsidy Amount Is Determined
The marketplace calculates your premium tax credit by finding the premium for the second-lowest-cost Silver plan (SLCSP) in your area and subtracting your required contribution. Your required contribution is your household income multiplied by the applicable percentage for your FPL bracket. If the SLCSP premium is $400/month and your required contribution (based on income) is $150/month, your tax credit is $250/month applied to any metal-tier plan you choose.
You can take the credit as advance payments (APTC) applied monthly to your premium, or as a lump-sum credit when you file your taxes. If your actual income ends up higher than estimated, you repay some or all of the excess advance credits. If your income is lower, you get additional credit at tax time.
Frequently Asked Questions
What is the 2026 ACA subsidy income limit for a single person?
For a single person (household of 1), the 2026 subsidy income range is $15,650 to $62,600. That is 100% to 400% of the 2025 federal poverty level, which ACA uses for 2026 plan year enrollment. Earn above $62,600 and you receive no premium tax credit. Earn below $15,650 in a Medicaid-expansion state and you qualify for Medicaid instead.
Did ACA subsidies change in 2026?
Yes. The enhanced premium tax credits from the American Rescue Plan (2021) and Inflation Reduction Act (2022), which were in effect through 2025, expired December 31, 2025. In 2026, the original ACA structure applies: subsidies are capped at 400% FPL, contribution percentages are higher (up to 9.96% of income at 300-400% FPL), and people above 400% FPL get no subsidy.
What is the 400% FPL cliff for 2026?
The 400% FPL cliff means that if your household income exceeds 400% of the federal poverty level, you receive zero premium tax credit. For a single person in 2026, that cutoff is $62,600. For a family of 4, it is $128,600. One dollar above the cutoff eliminates the entire subsidy. This cliff returned in 2026 after a five-year absence.
What are cost-sharing reductions (CSR) in 2026 and who qualifies?
Cost-sharing reductions (CSRs) lower your deductible, copays, and out-of-pocket maximum. In 2026, CSRs are available only to Silver plan enrollees earning 100-250% FPL. The three tiers: 100-150% FPL gets a 94% actuarial value Silver plan, 150-200% FPL gets 87%, and 200-250% FPL gets 73%. You must choose a Silver plan to unlock CSRs; Bronze, Gold, and Platinum plans do not qualify.
Can I get ACA subsidies if I have employer insurance?
No, unless your employer's plan is unaffordable. Employer-sponsored insurance (ESI) blocks marketplace subsidy eligibility if the employee-only premium costs less than 9.96% of your household income in 2026. If the ESI is unaffordable by that standard, you can decline it and get marketplace subsidies instead. Family members who are not offered affordable ESI can also qualify separately.
What is the income limit for a family of 4 to get ACA subsidies in 2026?
A family of 4 qualifies for premium tax credits if household income falls between $32,150 and $128,600 in 2026. For cost-sharing reductions (Silver plans only), the CSR ceiling for a family of 4 is $80,375 (250% FPL). Above $128,600, no subsidy is available. Below $32,150, Medicaid covers the family in expansion states.
What happens if I enroll mid-year in 2026 without a qualifying event?
Without a qualifying life event, you cannot enroll or switch plans mid-year in 2026. The year-round SEP for people below 150% FPL, which existed through 2025, was eliminated under the 2025 CMS Marketplace Integrity Rule and the One Big Beautiful Bill Act. If you missed open enrollment and have no qualifying event, your next opportunity is the 2027 open enrollment period starting November 1, 2026.
What counts as income for ACA subsidy eligibility?
ACA uses Modified Adjusted Gross Income (MAGI). MAGI includes wages, salaries, self-employment income, Social Security benefits (including non-taxable portions), investment income, rental income, and alimony received before 2019. It excludes child support received, gifts, inheritances, and workers compensation. Report your estimated 2026 annual MAGI when applying through the marketplace.
