ACA / Obamacare Subsidy Calculator

The Premium Tax Credit (PTC) caps your contribution toward the benchmark "silver plan" at a sliding percentage of household income - 0% near 150% of the Federal Poverty Level rising to about 8.5% at 400% FPL under the 2021-2025 ARPA/IRA enhancement. Those enhanced subsidies expired after 2025: unless extended, for 2026 the 400% FPL cliff returns (no credit above 400% FPL) and required contributions rise (up to about 9.96%). Congress did not extend them, so for 2026 this tool applies the cliff. The credit equals the benchmark premium minus your capped contribution. You can take it in advance (lower monthly premium) or reconciled at tax time on Form 8962.

Modified AGI (MAGI) - your tax AGI plus untaxed Social Security, tax-exempt interest, and foreign earned income. Do NOT include child support, gifts, SSI, Medicaid, or workers comp. Estimate carefully: overestimating income at enrollment costs you advance credit; underestimating risks owing it back at tax time. Update your income estimate via healthcare.gov whenever it changes by 10%+.

Generally not, unless the employer plan is "unaffordable" (employee-only premium exceeds 9.96% of household income in 2026) or fails minimum value (covers under 60% of expected costs). The 2023 family glitch fix extended subsidies to families when family coverage is unaffordable even if self-only coverage is not - significantly expanding eligibility for spouses and children of employed workers.

This is the "Medicaid coverage gap." In 10 non-expansion states (TX, FL, GA, TN, AL, MS, etc.), adults under 100% FPL get no ACA subsidies AND no Medicaid eligibility. The result: lowest-income workers may be uninsured. Workarounds include raising estimated income to qualify for the 100% FPL minimum (risky if actual income falls short), seeking community health centers, or pursuing state-specific charity care programs.

It is the second-lowest-cost silver plan in your area, and your subsidy is calculated from its cost, not from whatever plan you end up buying. You can apply the same dollar credit to a cheaper bronze plan to cut your net premium, or use it toward a gold plan and pay the difference out of pocket.

Report the change to the marketplace as soon as possible so your advance credit can be adjusted. If your final income comes in above what you projected, you will have to pay back part of the subsidy at tax time on Form 8962; if it comes in lower, you receive the difference as a refund.

It is an added reduction in deductibles, copays, and out-of-pocket maximums for households between 100% and 250% FPL, but it applies only if you enroll in a silver plan. Below 200% FPL, a silver plan with CSR can have lower out-of-pocket costs than a gold plan without it.