Affordable Care Act

Enhanced Premium tax credits

KFF Health News: How States Are Preparing for a Last-Minute ACA Deal

8 Things to Watch for 2026 ACA Open Enrollment

The ACA Marketplace Open Enrollment season begins November 1, and with it comes looming changes to the enhanced premium tax credits, increases in out-of-pocket premiums, and changes to Marketplace enrollment and eligibility rules.

Quick Take: ACA Insurers Are Raising Premiums by an Estimated 26%, but Most Enrollees Could See Sharper Increases in What They Pay

ACA Premium Payments Would More than Double on Average If Enhanced Tax Credits Expire

Most of the Public Say Congress Should Extend ACA Enhanced Tax Credits Set to Expire Next Year, Including Most Republicans and MAGA Supporters

Poll: 3 in 4 Adults Support Extending Enhanced Tax Credits for ACA Marketplace Coverage

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I entered estimated income information for next year on my Marketplace application. I expect my income next year will be much lower than it was this year because I had to change jobs. HealthCare.gov says there is a “data match” issue and that I must verify my income. What does that mean?

Sep 29, 2025
FAQs

A data match issue means the Marketplace is not able to verify the information on your application based on the data it has available to them. Usually, when this happens, HealthCare.
I have a college scholarship that covers my tuition and fees. Do I count that as income in determining my eligibility for subsidies?

Sep 29, 2025
FAQs

Scholarship and fellowship payments for tuition and fees and course-related expenses required of all students are not counted as income in determining your eligibility for premium tax credits. Scholarship payments for room and board are included in determining your eligibility.
I’m divorced and I pay alimony to my ex-spouse. Does that affect my income for determining eligibility for premium tax credits?

Sep 29, 2025
FAQs

Federal tax rules set out what is included in your household income. Eligibility for and the amount of premium tax credits are largely based on your household income.
What income is counted in determining my eligibility for premium tax credits?

Sep 29, 2025
FAQs

Eligibility for premium tax credits is based on your Modified Adjusted Gross Income, or MAGI. Click here for a list of the types of income that qualifies as MAGI.
How much can I earn and qualify for premium tax credits in the Marketplace?

Sep 29, 2025
FAQs

Premium tax credits are available to people who buy Marketplace coverage and whose income is at least as high as the federal poverty level. For an individual, that means an income of at least $15,650 in 2026. For a family of four, that means an income of at least $32,150 in 2026.
I’m low-income and currently enrolled in subsidized Marketplace coverage. I just found out I’m pregnant. Under my state’s rules, I now qualify for Medicaid. Do I have to drop out of the Marketplace coverage and enroll in Medicaid? If I don’t, will I have to pay back the premium tax credit?

Sep 29, 2025
FAQs

In nearly all states, pregnancy-related Medicaid provides the same (or similar) benefits as Medicaid for other adults and so is considered minimum essential coverage (MEC). In general, people who are eligible for other MEC are not eligible for advance premium tax credits (APTC).
I’m enrolled in COBRA, but I want to drop it. Does that affect my eligibility for Marketplace subsidies?

Sep 29, 2025
FAQs

You can only drop COBRA and sign up for a Marketplace plan and premium tax credits during Open Enrollment. You will have to drop your COBRA coverage effective the date your new Marketplace plan coverage begins.
My kids are eligible for the Children’s Health Insurance Program (CHIP). Can I enroll them in our Marketplace health plan and get premium tax credits for them instead?

Sep 29, 2025
FAQs

You can add your children to your Marketplace plan, but because they are eligible for your state’s Children’s Health Insurance Program (CHIP), they are not eligible for premium tax credits. The exception to that is if you live in a state that has a waiting period for enrolling in CHIP.
I’m under 26 and eligible to be covered as a dependent under my mom’s job-based policy. Mom no longer claims me as a tax dependent – I file my own taxes, though my income isn’t very high. If subsidized Marketplace coverage would be even more affordable to me, could I sign up for that instead?

Sep 29, 2025
FAQs

Yes. Although the general rule is that people are not eligible for Marketplace subsidies when they are also eligible for affordable job-based health coverage, a young adult is eligible for premium tax credits in the Marketplace as long as they are not claimed as a tax dependent by their parents.
My family and I are offered health benefits through my job, but we can’t afford to enroll. My employer pays 100% of the premium for workers, but contributes nothing toward the cost of adding my spouse and kids. Can we try to find a better deal on the Marketplace?

Sep 29, 2025
FAQs

Yes, you can. Since your employer pays 100% of the premium to cover you, you will not be eligible for premium tax credits, but your spouse and children may be eligible for financial assistance on the Marketplace, depending on the affordability of your employer’s family coverage.

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Affordable Care Act

Enhanced Premium tax credits

KFF Health News: How States Are Preparing for a Last-Minute ACA Deal

8 Things to Watch for 2026 ACA Open Enrollment

Quick Take: ACA Insurers Are Raising Premiums by an Estimated 26%, but Most Enrollees Could See Sharper Increases in What They Pay

ACA Premium Payments Would More than Double on Average If Enhanced Tax Credits Expire

Poll: 3 in 4 Adults Support Extending Enhanced Tax Credits for ACA Marketplace Coverage

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