ACA Income Limits 2026: Who Qualifies for Marketplace Subsidies?

The Affordable Care Act marketplace is entering a new chapter in 2026. After several years of expanded financial assistance under the American Rescue Plan Act and the Inflation Reduction Act, the enhanced subsidies that eliminated the 400% federal poverty level (FPL) income cliff have expired. Millions of Americans who received premium tax credits in recent years now face a hard income cutoff, higher contribution percentages, and in many cases, the loss of subsidies altogether.

This guide breaks down the 2026 ACA income limits, provides updated FPL amounts by household size, explains who still qualifies for premium tax credits, and walks you through a step-by-step process to check your eligibility.

What Changed: Enhanced Subsidies Have Expired

From 2021 through 2025, the enhanced subsidies made two major changes to ACA financial assistance. First, they eliminated the 400% FPL income cliff so that no household paid more than 8.5% of income toward the benchmark Silver plan, regardless of how much they earned. Second, they lowered the contribution percentages across every income bracket, making premiums cheaper for everyone from the lowest-income enrollees to middle-income families.

Those enhancements have now expired. For the 2026 plan year, the ACA reverts to its original subsidy structure. The key consequences include:

• The 400% FPL cliff is back. If your household income exceeds 400% of the federal poverty level by even one dollar, you receive zero premium tax credit.
• Higher contribution percentages. Consumers at every income level are expected to pay a larger share of their income toward premiums than they did under the enhanced structure.
• Millions lose assistance entirely. The Kaiser Family Foundation estimates that approximately 7 to 8 million people who received subsidies under the enhanced structure will either lose credits entirely or see significant reductions in their financial assistance.

2026 Federal Poverty Level Amounts by Household Size

The federal poverty level is updated annually by the Department of Health and Human Services. Your subsidy eligibility is determined by where your household income falls relative to these thresholds. Below are the approximate 2026 FPL guidelines for the 48 contiguous states and Washington, D.C. (Alaska and Hawaii have higher thresholds).

Household of 1 (single individual):

• 100% FPL: $15,540
• 138% FPL: $21,445 (Medicaid expansion threshold)
• 150% FPL: $23,310
• 200% FPL: $31,080
• 250% FPL: $38,850
• 300% FPL: $46,620
• 400% FPL: $62,160 (subsidy cutoff)

Household of 2:

• 100% FPL: $21,060
• 250% FPL: $52,650
• 400% FPL: $84,240 (subsidy cutoff)

Household of 3:

• 100% FPL: $26,580
• 250% FPL: $66,450
• 400% FPL: $106,320 (subsidy cutoff)

Household of 4:

• 100% FPL: $32,100
• 250% FPL: $80,250
• 400% FPL: $128,400 (subsidy cutoff)

Household of 5:

• 100% FPL: $37,620
• 400% FPL: $150,480 (subsidy cutoff)

Household of 6:

• 100% FPL: $43,140
• 400% FPL: $172,560 (subsidy cutoff)

For each additional person beyond six, add approximately $5,520 per year to the 100% FPL baseline. Multiply by four to determine the 400% FPL cutoff for your household size.

Income Ranges for Premium Tax Credits in 2026

With the return to the original ACA subsidy schedule, your expected premium contribution as a percentage of income is higher than it was under the enhanced structure. The 2026 contribution percentages (applied to the benchmark second-lowest-cost Silver plan) are approximately:

• 100% to 133% FPL: 2.07% of income
• 133% to 150% FPL: 3.10% to 4.14% of income
• 150% to 200% FPL: 4.14% to 6.52% of income
• 200% to 250% FPL: 6.52% to 8.33% of income
• 250% to 300% FPL: 8.33% to 9.83% of income
• 300% to 400% FPL: 9.83% of income
• Above 400% FPL: No subsidy available. You pay the full premium.

Compare these with the enhanced schedule, where the maximum contribution was 8.5% and people at 150% FPL or below paid nothing. Under the original schedule, even the lowest-income enrollees are expected to contribute roughly 2% of their income, and people in the 300% to 400% FPL range pay close to 10% — a substantial increase from the 6% to 8.5% they paid under the enhanced credits.

Example: A single individual earning $40,000 (approximately 257% FPL) would be expected to contribute about 8.5% of income under the original schedule, or $3,400 per year ($283 per month). If the benchmark Silver plan in their area costs $550 per month ($6,600 per year), the premium tax credit would be $6,600 minus $3,400, equaling $3,200 per year or about $267 per month. Under the enhanced schedule, this same person would have paid roughly 6.5% of income ($2,600), receiving a larger credit of $4,000 per year.

Who Lost Subsidies vs. Who Still Qualifies

The expiration of the enhanced subsidies does not affect everyone equally. Here is a breakdown of how different groups are impacted:

People Who Lost Subsidies Entirely

• Households above 400% FPL. Under the enhanced structure, these households still received credits if the benchmark plan exceeded 8.5% of income. Now they receive nothing. A single person earning $65,000 or a family of four earning $130,000 faces full-price premiums.
• Middle-income older adults. Because insurers can charge older enrollees up to three times more than younger ones, adults aged 55 to 64 earning above 400% FPL are hit especially hard. Their premiums can easily exceed $1,000 per month with no subsidy to offset the cost.

People With Reduced Subsidies

• Households between 150% and 400% FPL. These consumers still qualify for premium tax credits, but their expected contribution percentage has increased. A family at 200% FPL that paid 0% to 2% of income under the enhanced schedule now pays 4.14% to 6.52%. Monthly premiums after subsidies will be noticeably higher.

People Whose Subsidies Are Largely Unchanged

• Households at or near 100% FPL. The lowest-income enrollees see the smallest dollar change because their contribution percentages were already very low. However, moving from 0% to approximately 2% of income still represents new out-of-pocket costs.
• CSR-eligible enrollees (100% to 250% FPL). Cost-sharing reductions on Silver plans were not part of the enhanced subsidy legislation and remain unchanged. If you qualify for CSRs, you still receive the same reduced deductibles and copays.

Cost-Sharing Reduction (CSR) Silver Plan Eligibility

Cost-sharing reductions remain a critically important benefit for lower-income marketplace enrollees in 2026. CSRs are separate from premium tax credits and were not affected by the enhanced subsidy expiration. They reduce your deductible, copays, coinsurance, and maximum out-of-pocket costs when you enroll in a Silver plan through the ACA marketplace.

CSR eligibility by income tier:

• 100% to 150% FPL: Silver plan enhanced to approximately 94% actuarial value. Deductibles as low as $0 to $75. Out-of-pocket maximum around $1,300. This is better coverage than most Platinum plans at a fraction of the premium.
• 150% to 200% FPL: Silver plan enhanced to approximately 87% actuarial value. Deductibles and out-of-pocket maximums significantly reduced, comparable to Gold plan coverage.
• 200% to 250% FPL: Silver plan enhanced to approximately 73% actuarial value. More modest but still meaningful reductions in deductibles and maximum out-of-pocket costs compared to a standard Silver plan at 70% actuarial value.

Important: CSRs are only available on Silver plans purchased through the marketplace. If you are eligible for cost-sharing reductions and choose a Bronze, Gold, or Platinum plan instead, you will not receive any CSR benefits. For most people earning between 100% and 250% FPL, a CSR-enhanced Silver plan offers the best overall value in the marketplace even with the higher post-enhanced contribution percentages.

The Medicaid Gap: States Where Low-Income Adults Fall Through the Cracks

ACA premium tax credits begin at 100% of the federal poverty level. The law was designed assuming all states would expand Medicaid to cover adults up to 138% FPL, so there would be no gap between Medicaid and marketplace subsidies. However, after the Supreme Court made Medicaid expansion optional in 2012, approximately ten states have still not expanded their programs as of 2026.

In non-expansion states, adults without dependent children often do not qualify for Medicaid regardless of how low their income is. If their income also falls below 100% FPL, they cannot access marketplace subsidies either. This group — estimated at approximately 1.5 million adults nationwide — is caught in the coverage gap.

States that have not expanded Medicaid as of 2026 include:

• Texas
• Florida
• Georgia
• Mississippi
• Alabama
• Tennessee
• South Carolina
• Kansas
• Wisconsin (partial expansion — covers adults up to 100% FPL but not the full 138%)
• Wyoming

If you live in one of these states and your income falls below 100% FPL, your options are limited. Community health centers provide primary care on a sliding-fee scale, and hospitals must provide emergency care regardless of ability to pay. Some states offer limited state-funded health programs. However, none of these alternatives provide the comprehensive, continuous coverage available through Medicaid or the ACA marketplace.

How to Estimate Your MAGI for ACA Purposes

The marketplace uses your modified adjusted gross income (MAGI) — not your gross income or take-home pay — to determine subsidy eligibility. Accurately estimating your MAGI is critical, because overestimating means you may receive too little subsidy throughout the year, while underestimating could result in owing money back to the IRS at tax time.

MAGI includes:

• Wages and salary
• Self-employment income (net profit)
• Unemployment compensation
• Social Security benefits (including the taxable and non-taxable portions)
• Investment income (capital gains, dividends, interest)
• Retirement account distributions (401(k), IRA withdrawals)
• Rental and royalty income
• Alimony received (for divorce agreements finalized before 2019)
• Tax-exempt foreign income and tax-exempt interest

MAGI does not include:

• Child support received
• Gifts and inheritances
• Veterans' disability payments
• Supplemental Security Income (SSI)
• Workers' compensation

Tip: If your income is close to the 400% FPL threshold, certain strategies may help you stay below the cutoff. Contributing to a traditional 401(k) or traditional IRA reduces your AGI. HSA contributions also lower AGI. Self-employed individuals can deduct the employer-equivalent portion of self-employment tax and health insurance premiums. Consult a tax professional if you are near the cliff to understand your options.

Step-by-Step: How to Check Your ACA Subsidy Eligibility

Follow these steps to determine whether you qualify for marketplace subsidies in 2026 and estimate how much you could save:

1. Estimate your 2026 household income. Use your most recent tax return as a starting point. Add up expected wages, self-employment income, investment income, Social Security benefits, and any other MAGI components. Adjust for anticipated changes such as raises, job changes, or retirement.
2. Determine your household size. Your ACA household includes you, your spouse (if filing jointly), and anyone you claim as a tax dependent — even if they do not need health coverage. Do not include roommates, unmarried partners (unless they are tax dependents), or non-dependent adult children.
3. Compare your income to the FPL. Using the FPL table above, find the 100% and 400% FPL amounts for your household size. If your projected income falls between these two numbers, you likely qualify for premium tax credits. If it falls between 100% and 250% FPL, you also qualify for cost-sharing reductions on Silver plans.
4. Check for disqualifying coverage. You cannot receive premium tax credits if you are eligible for Medicare, Medicaid, CHIP, or affordable employer-sponsored insurance that meets minimum value. Employer coverage is considered affordable in 2026 if your share of the self-only premium does not exceed approximately 9.02% of household income.
5. Use an online calculator. The KFF Health Insurance Marketplace Calculator and the HealthCare.gov "See Plans and Prices" tool both allow you to enter your income, household size, zip code, and ages to receive a personalized subsidy estimate. No account or personal information is required to browse.
6. Apply through the marketplace. Visit HealthCare.gov or your state's exchange to create an account and submit a formal application. The marketplace will verify your income, citizenship or immigration status, and other eligibility factors. It will then display your subsidy amount and the plans available to you with prices shown after applying your credit.
7. Choose how to receive your credit. You can take the advance premium tax credit (APTC) to lower your monthly premiums immediately, or you can pay full price each month and claim the entire credit as a lump sum when you file your federal tax return using IRS Form 8962. Most people choose the advance option.
8. Report changes throughout the year. If your income, household size, or coverage situation changes during 2026, report it to the marketplace immediately. This ensures your subsidy stays accurate and minimizes the chance of owing money back at tax time.

Special Considerations for Near-Cliff Earners

The return of the 400% FPL cliff creates a particularly dangerous dynamic for people whose income hovers near the cutoff. Because exceeding 400% FPL by any amount disqualifies you from all premium tax credits, a small income increase could cost you thousands of dollars in lost subsidies.

Example: A single individual earning $62,000 (just below 400% FPL) might receive a premium tax credit of $1,500 to $2,500 per year depending on their age and local premiums. If that same person earns $63,000 — just $1,000 more — they lose the entire credit and could pay $1,500 to $2,500 more for the same coverage. The effective marginal tax rate at the cliff can exceed 100%.

Strategies for managing income near the cliff:

• Maximize pre-tax retirement contributions. Contributions to a traditional 401(k) or traditional IRA reduce your AGI dollar for dollar, potentially bringing you below the 400% FPL threshold.
• Contribute to a Health Savings Account (HSA). If you are enrolled in an HSA-eligible high-deductible health plan, HSA contributions lower your AGI and can be used for qualifying medical expenses tax-free.
• Time capital gains and retirement distributions carefully. Selling investments or taking IRA distributions can push your income above the cliff. If possible, defer these transactions to years when your income is already above 400% FPL.
• Consult a tax professional. A CPA or enrolled agent familiar with ACA subsidies can help you model different income scenarios and identify deductions or strategies specific to your situation.

The Bottom Line

The 2026 ACA income limits represent a significant shift for marketplace enrollees. With the enhanced subsidies expired, the hard 400% FPL cutoff returns, contribution percentages rise, and millions of Americans face higher premiums or the complete loss of financial assistance. However, the core ACA subsidy structure remains intact for households between 100% and 400% FPL, and cost-sharing reductions on Silver plans continue to provide valuable savings for those earning between 100% and 250% FPL.

The most important steps you can take right now:

• Estimate your MAGI carefully — know where you stand relative to 400% FPL
• Choose a Silver plan if you earn between 100% and 250% FPL to capture cost-sharing reductions
• Explore income management strategies if you are close to the 400% FPL cliff
• Report income changes promptly to keep your advance credit aligned with your actual income
• File Form 8962 with your tax return to reconcile your premium tax credit and avoid future enrollment issues

If you are unsure about your eligibility, use the KFF Marketplace Calculator for a quick estimate or browse plans on HealthCare.gov without creating an account. You can also contact a licensed insurance agent or a free marketplace Navigator for personalized guidance. Even with the subsidy reductions, ACA marketplace plans remain the best source of comprehensive, guaranteed-issue health coverage for people who do not have employer or government insurance. The first step is simply checking what you qualify for during open enrollment or a Special Enrollment Period.