2027 ACA Subsidy Income Limits: Who Qualifies for Health Insurance Savings?

2027 ACA subsidy eligibility at a glance

• Income: Generally 100%–400% of the 2026 FPL for your tax household.
• Coverage: Enroll through a federal or state Marketplace.
• Other coverage: Affordable employer insurance that meets minimum value, or eligibility for Medicaid, Medicare, or certain other coverage, can block the credit.
• Taxes: You generally cannot be another taxpayer’s dependent. Married applicants usually must file jointly.
• Immigration: From January 1, 2027, federal savings are limited to U.S. citizens and nationals, lawful permanent residents, Cuban or Haitian entrants, and COFA migrants.

2027 ACA subsidy income limits

The standard federal Premium Tax Credit income range is 100%–400% FPL under current law. The tables below show the annual household MAGI thresholds for 2027 coverage, using the 2026 HHS poverty guidelines.

48 contiguous states and Washington, D.C.

Alaska

Hawaii

For each additional person above eight, add $5,680/$22,720 in the contiguous states and D.C., $7,100/$28,400 in Alaska, or $6,530/$26,120 in Hawaii (lower/upper limit).

Why 2027 coverage uses the 2026 poverty guidelines

IRS rules use the latest HHS poverty guidelines available on the first day of open enrollment. When 2027 enrollment opened on November 1, 2026, the 2026 guidelines were the latest published. They therefore set the 2027 income thresholds. See the HHS 2026 poverty guidelines and HealthCare.gov’s FPL explanation.

How 2027 Marketplace subsidies work

The Premium Tax Credit (PTC) reduces premiums for qualifying Marketplace plans. You can receive it in advance each month or claim it on your federal tax return.

• Advance Premium Tax Credit (APTC): The Marketplace sends estimated assistance directly to your insurer each month; you pay the balance.
• Tax-time reconciliation: File IRS Form 8962 after the year ends to compare the allowed PTC with APTC paid for you. You may receive an additional credit or owe money back.
• Cost-Sharing Reductions (CSR) lower deductibles, copayments, coinsurance, and the out-of-pocket maximum. Eligible households with income between 100% and 250% FPL may qualify, but generally must enroll in a Silver plan to receive them. PTC can be used with plans in other metal levels.

How much of your income are you expected to pay?

The IRS sets the expected household contribution as a percentage of annual income. That amount is divided by 12 for the monthly benchmark calculation.

Within a bracket where the initial and final percentages differ, the applicable percentage increases gradually as household income rises from the bottom to the top of that bracket. It stays the same in brackets where the two percentages match.

For each month, the PTC is generally the smaller of (1) your selected qualifying plan’s premium or (2) the local second-lowest-cost Silver premium minus your expected contribution. That contribution uses your income and the applicable IRS percentage above. See IRS Revenue Procedure 2026-26 and 26 U.S. Code Section 36B.

Who qualifies for ACA subsidies in 2027?

Income alone does not guarantee eligibility.

Household size and MAGI

Your tax household is based on your federal return, not everyone at your address. It usually includes you, your spouse, and your dependents. Household size determines the FPL figure. A dependent’s income generally counts only if the dependent must file a federal return.

For the PTC, household income is modified adjusted gross income (MAGI): adjusted gross income (AGI), plus tax-exempt interest, excluded foreign income, and nontaxable Social Security benefits. Wages, self-employment income, unemployment, investment income, most taxable retirement distributions, and Social Security generally count. SSI does not count; neither do child support, gifts, loans, veterans’ disability benefits, or workers’ compensation.

Estimate all of your 2027 income, not just your current paycheck. See the Marketplace income guide.

If you receive SSI or other benefits and are unsure what counts as income, our guide to 2027 SSI payment amounts explains the difference between SSI and Social Security.

Employer coverage and government programs

An employer plan generally blocks the employee’s PTC if it is affordable and meets minimum value. For 2027, the lowest-cost self-only plan is affordable when the employee’s required contribution is 10.22% or less of household income. A contribution above 10.22% generally makes the offer unaffordable for PTC purposes, assuming other rules are met. The plan must also meet minimum value (HealthCare.gov, IRS Revenue Procedure 2026-26, and 26 U.S.C. §36B).

Family members are tested separately using the premium for coverage that includes the employee and the family members offered the plan; they may qualify even if the employee’s own offer is affordable. Minimum value generally means the plan pays at least 60% of covered costs and substantially covers inpatient hospital and physician services. Eligibility for Medicaid, Medicare, CHIP, or certain other qualifying coverage generally blocks PTC for months that coverage is available.

If Medicaid may be a better fit for your household, see our Medicaid eligibility and coverage guide for state-by-state rules and application steps.

Tax filing rules

You generally must file a federal return and reconcile APTC on IRS Form 8962. Married applicants usually must file jointly, with exceptions for some people living apart who qualify under head-of-household, domestic-abuse, or spousal-abandonment rules. You generally cannot receive the credit if another taxpayer can claim you as a dependent.

A limited exception may apply if you gave accurate information, the Marketplace estimated income of at least 100% FPL, you received APTC for at least one month, and your final income fell below 100%. A separate below-100%-FPL exception for certain lawfully present immigrants ended with tax year 2025.

Immigration eligibility changes starting January 1, 2027

A 2025 federal law limits federal Marketplace savings beginning January 1, 2027 to:

• U.S. citizens and nationals;
• Lawful permanent residents;
• Cuban or Haitian entrants; and
• COFA migrants (people from Micronesia, the Marshall Islands, or Palau living in the United States under the Compact of Free Association).

Eligible people in these categories may receive federal PTC and income-based CSR. Other lawfully present immigrants may buy full-price Marketplace coverage but generally cannot receive federal savings.

DACA recipients cannot enroll in Marketplace coverage under current federal rules. An employment authorization document (EAD) alone does not establish eligibility; the underlying immigration category controls. State programs may use different rules. See HealthCare.gov’s immigration-status list, its lawfully present immigrant guidance, and CMS’s 2027 guidance. CMS explains the DACA Marketplace change in its 2025 final rule fact sheet.

What changed from earlier years?

The enhanced federal PTCs expired at the end of 2025. Under current law, the standard 400% FPL income ceiling applies again for 2026 and 2027 coverage.

For tax year 2026 onward, repayment caps for excess APTC no longer apply. You must repay the full excess credit. Reconcile 2026 coverage on the return filed in 2027 and 2027 coverage on the return filed in 2028. Update your Marketplace application promptly when income or household details change. See the IRS explanation.

As of November 6, 2026, no law had changed the 2027 rules. The House passed an amended version of H.R. 1834 230–196 on January 8, 2026. Although the original bill’s short title is Breaking the Gridlock Act, CBO’s estimate of the House-passed amendment says it would extend enhanced PTCs through 2028. The Senate placed the bill on its calendar on February 10; it had not become law by the research cutoff. See CBO’s estimate and the official Senate calendar.

Other proposals remained bills, not law: H.R. 10730, the Healthy Communities Act of 2026, would remove the 400% FPL ceiling. H.R. 10692 and S. 5619, both the Restoring Essential Plan Coverage Act, would restore credits for additional lawfully present immigrants. All three proposals had been referred to committees.

2027 open enrollment deadlines

On HealthCare.gov, open enrollment runs November 1, 2026, through January 15, 2027. Enroll by December 15, 2026 for coverage starting January 1, 2027. Applications submitted from December 16 through January 15 generally start February 1.

State Marketplaces may set different dates. Covered California and GetCoveredNJ list enrollment through January 31, 2027. Enroll by December 31 for January 1 coverage; January enrollments generally begin February 1. Check your state Marketplace.

After open enrollment, you generally need a Special Enrollment Period, such as after losing coverage, marriage, birth or adoption, or a qualifying move. Medicaid and CHIP applications are open year-round.

Not sure which assistance program to check first? Try our Benefits Checker to narrow down the programs that may fit your situation.

What 2027 premiums may cost

KFF reported a 13% national average increase in finalized 2027 benchmark Silver premiums—11% in HealthCare.gov states and 16% in state-based Marketplace states. This is not a 13% increase for every enrollee. Actual costs depend on age, county, plan, income, and financial assistance.

State-funded help may be available

Some states add their own assistance. These programs have separate eligibility rules and are not federal PTC.

• New Jersey: The state-funded New Jersey Health Plan Savings (NJHPS) program supplements federal APTC. For 2027, GetCoveredNJ lists eligibility up to 600% FPL—$95,760 for one person or $198,000 for a family of four. Apply through GetCoveredNJ.
• California: Covered California says its state-funded subsidy program will help eligible residents with 2027 income up to 200% FPL—$31,920 for one person or $66,000 for a family of four. This is separate from federal PTC. See Covered California’s 2027 program announcement.

State assistance may use different income and immigration rules. Check the state Marketplace.

Because state programs can overlap with Medicaid, food, utility, and other assistance, our overview of how state benefits work can help you understand where to look next.

How to apply for 2027 Marketplace coverage

Certified Navigators and assisters provide free help through HealthCare.gov’s local help finder or your state Marketplace. Report changes and reconcile APTC yearly.

What if your income is below the subsidy limit?

Below 100% FPL, most people do not qualify for federal PTC. In Medicaid expansion states, many adults qualify up to about 138% FPL. In non-expansion states, some adults fall into the Medicaid coverage gap: their income is too low for Marketplace subsidies but they do not qualify for Medicaid. Children may qualify for Medicaid or CHIP at higher income levels. Applications are generally open year-round.

Medicaid community engagement requirements in 2027

The federal community engagement requirement does not apply to every Medicaid enrollee. It generally covers certain non-pregnant adults ages 19–64 who are not entitled to or enrolled in Medicare and who are in the Medicaid expansion adult group and specified Section 1115 demonstration populations, subject to statutory exclusions and exceptions. The standard is generally 80 hours per month of qualifying work, community service, or an approved work program. Half-time education or a specified earnings level may also satisfy it. Exceptions include some people who are pregnant or postpartum, disabled or medically frail, caring for a child under 14 or a person with a disability, and American Indians and Alaska Natives.

States generally must implement the requirement by January 1, 2027. Federal law allows a state that is making a good-faith effort to receive an implementation delay, potentially through December 31, 2028. See the CMS interim final rule fact sheet and Medicaid.gov implementation information.

For a deeper breakdown of the 80-hour rule, exemptions, and state deadlines, read our guide to Medicaid work requirements in 2027.

A person who otherwise qualifies for Medicaid but is denied or disenrolled solely for failing the community engagement requirement is treated as eligible for Medicaid minimum essential coverage for PTC purposes during the affected months. The person therefore does not automatically qualify for Marketplace subsidies for those months. The October 15, 2026 Treasury and IRS proposal discusses this interaction; it was proposed, not final, as of November 6, 2026.

Read DollarRelief’s Medicaid eligibility guide for income rules and state differences.

Frequently asked questions