2027 Open Enrollment Starts Nov 1

Medicaid Income Limits 2026 & ACA Subsidy Calculator.

Navigate the complexities of ACA subsidies, Medicaid eligibility, and Federal Poverty Levels with a precision-engineered calculator. Designed for clarity, transparency, and 2026 accuracy.

Start Full Assessment → Medicaid by State

Enter your household income, size, and state below to estimate your 2027 (or 2026) Affordable Care Act Premium Tax Credit — the monthly amount that offsets your Marketplace premium — and check Medicaid eligibility for your state.

1 Your Household

2 Who Needs Coverage?

Enter the age of each person who needs marketplace coverage. Children under 21 are rated the same. Household members with other coverage (employer, Medicare, etc.) should not be listed.

Any tobacco users? (may affect premium)

Your 2027 Subsidy Estimate

Estimated Monthly Subsidy
$0
Subsidy Cliff Warning: Your income is close to the 400% FPL cutoff. A small increase in income could eliminate your entire subsidy. Consider contributing to a traditional IRA or HSA to reduce your modified adjusted gross income (MAGI).
Income as % of FPL
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Monthly Premium After Subsidy
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Benchmark Silver plan
Annual Contribution
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Monthly Premium Breakdown
Full Premium Subsidy Covers You Pay
Compare with the enhanced subsidies that expired after 2025
2025 rules (enhanced)
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Monthly premium you'd pay
→
2027 (current law)
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Monthly premium you'll pay
Your monthly cost increases by --
Guides & Analysis

Beyond the Calculator

The math behind the numbers, the rules behind the math, and the changes that just kicked in for 2026.

All guides

Key Income Thresholds

Household Size 138% FPL (Medicaid, 2026) 400% FPL (2027 Subsidy Cliff)
1 Individual $22,025 $63,840
2 People $29,863 $86,560
3 People $37,702 $109,280
4 People $45,540 $132,000

Note: Thresholds are based on 2026 FPL guidelines for the 48 contiguous states + D.C. For 2026 coverage, the subsidy cliff is measured against 2025 guidelines ($62,600 for one person, $128,600 for four). Alaska and Hawaii use adjusted FPL. Medicaid eligibility also depends on whether your state has expanded Medicaid under the ACA.

Navigating Medicaid Expansion?

States set their own eligibility criteria. Some expand coverage to 138% of the FPL; others limit Medicaid to parents, pregnant women, and the disabled.

Explore state-by-state guide →

How the ACA Subsidy Calculator Works

The Affordable Care Act (ACA) provides premium tax credits to help eligible individuals and families afford health insurance purchased through the Health Insurance Marketplace. This calculator estimates your 2026 subsidy using the official ACA formula that returns after the American Rescue Plan Act (ARPA) enhanced subsidies expire at the end of 2025.

The Subsidy Formula

Your premium tax credit is calculated as:

Subsidy = Benchmark Premium − Expected Contribution

Where your Expected Contribution equals your household income multiplied by an applicable percentage that increases with income. The benchmark premium is the cost of the second-lowest-cost Silver plan (SLCSP) in your area, adjusted for the ages of the people in your household.

What Changed After 2025

Under the ARPA (2021-2025), nobody paid more than 8.5% of income for the benchmark plan, and people below 150% FPL paid nothing. Since 2026, required contributions are significantly higher: for 2027, households at 150% FPL pay 4.3% of income and those at 300-400% FPL pay 10.22%, and the 400% FPL subsidy cliff is back — meaning if your income exceeds 400% of the Federal Poverty Level, you get zero subsidy regardless of how expensive premiums are.

Key Income Thresholds

Frequently Asked Questions

What is the ACA subsidy cliff?
The ACA subsidy cliff is the income threshold at 400% of the Federal Poverty Level where marketplace subsidies completely cut off. For 2027 coverage, if your household income exceeds 400% FPL ($63,840 for a single person or $132,000 for a family of 4; $62,600 and $128,600 for 2026 coverage), you receive zero premium tax credit — even if you're just $1 over the limit. This cliff was temporarily eliminated by the American Rescue Plan Act (2021-2025), which capped contributions at 8.5% of income for all income levels. With the cliff back in place, families near the threshold should carefully manage their Modified Adjusted Gross Income (MAGI) through strategies like traditional IRA or HSA contributions.
What happened to the enhanced subsidies?
The American Rescue Plan Act (ARPA) of 2021 significantly boosted ACA subsidies by lowering the percentage of income people had to pay toward premiums and eliminating the 400% FPL subsidy cliff. Under ARPA, people below 150% FPL paid $0, and nobody paid more than 8.5% of income. These enhanced subsidies were extended through 2025 by the Inflation Reduction Act. However, Congress did not extend them further, so in 2026 the original ACA subsidy formula returns. For a family of 4 earning $80,000, this could mean thousands of dollars more in annual premiums compared to what they paid in 2025. Read our 2026 ACA subsidy cliff explained for a full breakdown of what changed and who is affected.
Am I eligible for Medicaid instead?
If your income is below 138% of the Federal Poverty Level and you live in one of the 40 states (plus D.C.) that have expanded Medicaid, you likely qualify for Medicaid instead of marketplace subsidies. Medicaid provides free or very low-cost coverage. In the 10 states that have not expanded Medicaid (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming), adults with income below 100% FPL may fall into the "coverage gap" — they earn too much for traditional Medicaid but too little for marketplace subsidies. Wisconsin is a special case: it covers adults up to 100% FPL without formal expansion.
What is the benchmark Silver plan?
The Second Lowest Cost Silver Plan (SLCSP) is the plan used to calculate your premium tax credit. It's the second-cheapest Silver-tier plan available in your rating area. Your subsidy equals the SLCSP premium minus your expected contribution based on income. You can apply your subsidy to any marketplace Metal tier — Bronze, Silver, Gold, or Platinum. Choosing a Bronze plan (with lower premiums) might result in a $0 monthly cost after the subsidy. Choosing a Gold or Platinum plan means you'd pay the difference between that plan's premium and your subsidy amount.
How accurate is this calculator?
This calculator uses the official Federal Poverty Level guidelines, the IRS applicable percentage tables for 2026 and 2027 (Rev. Proc. 2025-25 and 2026-26), federal age curve rating factors, and 2026 state-average benchmark premiums from KFF (2027 rates are published shortly before open enrollment). Because premiums vary by county and rating area, the benchmark premiums used here are statewide averages and may differ from your exact location. For the most accurate subsidy amount and to see actual plan options, visit healthcare.gov during Open Enrollment and enter your specific ZIP code and household information.
What are Cost-Sharing Reductions?
Cost-Sharing Reductions (CSRs) lower your out-of-pocket costs — deductibles, copays, and coinsurance — when you enroll in a Silver plan through the marketplace. CSRs are available to households with income between 100% and 250% of FPL. Below 150% FPL, you get a Silver plan that covers about 94% of your healthcare costs (vs. the standard 70%). Between 150-200% FPL, the plan covers about 87%. Between 200-250% FPL, about 73%. CSRs are only available on Silver plans, which is why Silver is often the best value for lower-income households even if a Bronze plan has a lower premium.

Medicaid Eligibility by State

Select your state for detailed income limits, eligibility requirements, and how to apply. State Medicaid expansion status directly affects your options.

Expansion States

40 + D.C.

    Non-Expansion States

    10 States
      ⚠ Wisconsin covers adults up to 100% FPL through BadgerCare Plus without formal expansion.