What is the 400% FPL cliff?

With enhanced subsidies expired in 2026, earning over 400% of the Federal Poverty Level can mean losing the entire premium tax credit.

2026 Health Insurance Subsidy Estimator — ACA Premium Tax Credit Calculator

Q: Is this an exact quote?

No — it estimates using national-average benchmark premiums. Actual subsidies depend on local plan prices; get a real quote for exact numbers.

Medicare at a glance (2026 estimates)

Part B standard premium

$202.90/mo

higher at high incomes (IRMAA)

Eligibility age

or via disability

Part A (hospital): usually $0 premium if you/your spouse paid Medicare taxes 10+ years.
Part B (medical): ~$202.90/mo standard; higher for incomes above the IRMAA thresholds.
Part D (drugs): varies by plan; an IRMAA surcharge applies at higher incomes.
Medicare Advantage (Part C): bundles A/B/often D; many $0-premium plans but network limits.
Medigap (supplement): ~$100–$300/mo, fills Original Medicare's gaps; see any doctor that takes Medicare.
Enroll in your 7-month Initial Enrollment Period around your 65th birthday to avoid late penalties.

General information only — not insurance or financial advice. Confirm current premiums and your options at Medicare.gov.

How ACA subsidies work in 2026

The premium tax credit (PTC) caps what you pay for a benchmark "silver" plan at a set percentage of your income. You estimate your household's income as a percentage of the Federal Poverty Level (FPL); the law sets an applicable percentage (2.1% up to about 9.96%) you're expected to contribute; the subsidy covers the rest of the benchmark premium. In 2026 the enhanced pandemic-era subsidies have expired, so the 400% FPL cliff is back — above 400% FPL you generally get no credit and pay full price.

The math (worked example)

A 2-person household earning $48,000 is at ~222% of FPL. Their applicable percentage interpolates to ~7.40%, so their required annual contribution is $48,000 × 7.40% ≈ $3,553, or ~$296/month. Against an estimated $490/month benchmark plan (age 45), the credit is $490 − $296 = ~$194/month (~$2,327/year). This calculator runs exactly that math for your numbers.

Cost-sharing reductions (CSR)

Households between 100% and 250% of FPL who choose a silver plan also qualify for cost-sharing reductions — lower deductibles, copays and out-of-pocket maximums — on top of the premium credit.

Estimate only — not insurance, tax, or financial advice. Benchmark premiums are rough national averages; actual subsidies depend on your ZIP code, the specific plans offered, and your verified income. Alaska and Hawaii use higher poverty guidelines. Confirm your real numbers at HealthCare.gov or your state marketplace.

FAQ

Who qualifies for an ACA subsidy in 2026?

Generally households between 100% and 400% of the Federal Poverty Level who aren't offered affordable employer coverage. Below 100% FPL you may qualify for Medicaid; above 400% the credit phases out under 2026 rules.

What income do I use?

Modified Adjusted Gross Income (MAGI) for your tax household — roughly your expected annual income for the coverage year.

What's the 400% cliff?

With the enhanced subsidies expired in 2026, earning even $1 over 400% of FPL can mean losing the entire premium tax credit. Estimate carefully near that line.

Is this an exact quote?

No — it's an estimate using national-average benchmark premiums. Your real subsidy depends on local plan prices. Use the quote link for actual numbers.