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% at 150% of the Federal Poverty Level rising to 8.5% at 400%+ FPL (post-IRA extension). 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 9.12% 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, NC pre-2023, 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.