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ACA plans · 2026 guide

ACA plans —
the guarantees, the costs, and the catches.

ACA plans are regulated health insurance sold either through the official marketplace (healthcare.gov or a state exchange) or directly from a carrier off-exchange. Both channels offer the same ACA protections — guaranteed coverage of pre-existing conditions, ten essential health benefits, and guaranteed issue regardless of health status. The critical difference is that subsidies are only available through the official exchange. They also come with real trade-offs: premiums that rose an average of 26% in 2026, a subsidy system that many people find confusing to navigate, deductibles that now average a record $3,786 before most non-preventive care kicks in, and provider networks that have been shrinking in many states. Whether an ACA plan is the right choice depends heavily on your income, your health needs, and where you live. This page covers both sides honestly.

For individuals under 65 · Not employer-sponsored · Updated June 2026 · KFF.org data
2026 is a significantly different year for ACA marketplace coverage
The enhanced premium tax credits in place from 2021 through 2025 expired December 31, 2025. As a result: benchmark premiums increased an average of 26% nationally; the 400% FPL subsidy cliff returned; and an estimated 3–5 million people have left the ACA marketplace. If you were enrolled in 2025, your costs in 2026 are likely higher than before. This page reflects 2026 rules and data. Sources: KFF.org, IRS Rev. Proc. 2025-25.
−13%
Drop in ACA enrollment, 2025→2026
+26%
Average benchmark premium increase, 2026
$3,786
Average 2026 ACA deductible — record high
$62,600
2026 subsidy cliff — single adult (400% FPL)
What is an ACA plan

What ACA plans guarantee — and what they don’t

ACA plans — also called Obamacare plans — are health insurance policies sold either through the official marketplace (healthcare.gov or a state-run exchange) or directly from a carrier off-exchange. Every ACA-compliant plan must meet the same federal requirements regardless of which channel it is sold through. The distinction matters for one reason: subsidies (premium tax credits and cost-sharing reductions) are only available through the official exchange. Off-exchange ACA plans carry identical coverage rules — same pre-existing condition protections, same essential health benefits, same guaranteed issue — but are paid at full price. Some carriers also offer plan designs exclusively off-exchange that are not available through the marketplace at all.

The regulatory guarantees are real and meaningful. But they come paired with structural trade-offs that are just as real: rising premiums, high deductibles, a subsidy system with a hard income cliff, and networks that vary significantly by state and county. Here is what the guarantees actually include — and where the limits are.

Pre-existing conditions
ACA plans cannot deny coverage or charge more based on your health history. This is guaranteed by federal law under the Affordable Care Act. No medical underwriting, no exclusions for pre-existing conditions, no waiting periods for coverage.
Ten essential health benefits
Every ACA plan must cover: hospitalization, emergency care, outpatient care, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative services, laboratory services, preventive care, and pediatric care. No ACA plan can exclude any of these categories.
Income-based subsidies
Premium tax credits are available to households with incomes between 100% and 400% of the federal poverty level. In 2026, that is roughly $15,650 to $62,600 for a single adult. Above 400% FPL, no subsidy is available — this is the subsidy cliff. Use the subsidy calculator on our homepage to estimate your credit.
The trade-offs
High and rising premiums
ACA benchmark premiums increased an average of 26% in 2026 — the largest single-year increase since 2018. For a 40-year-old in Texas, the unsubsidized benchmark silver plan now costs $661/month. For a 60-year-old in the same state, it is significantly higher. If your income is above $62,600 (the 400% FPL cliff for a single adult), you pay the full amount with no help. The average annual premium for unsubsidized enrollees in 2026 is approximately $8,500 — up from $4,400 in 2025. Source: KFF.org.
Record-high deductibles in 2026
The average ACA marketplace deductible hit a record high of $3,786 in 2026 — up 37% from 2025. This means most non-preventive care does not kick in until you have spent nearly $4,000 out of pocket first. The increase was driven largely by enrollees moving from silver to bronze plans to reduce monthly premiums after the enhanced subsidy expiration. If you selected a bronze plan to lower your monthly cost, be aware that your out-of-pocket exposure in the event of illness is substantial. Source: KFF.org, May 2026.
Shrinking provider networks in many states
ACA plans use in-network provider lists that restrict which doctors and hospitals your coverage applies to at the lower in-network rate. How wide or narrow a network is varies by insurer and plan design — not by metal tier. A bronze plan from one carrier may include more hospitals and specialists than a gold plan from another carrier in the same county. Narrow network plans have become more common across all metal tiers as cut-rate insurers have entered more markets, and CMS noted in its 2026 final rule that some plans are built around “narrow — or even non-existent — provider networks.” Before enrolling, verify that your current doctors and any specialists you see regularly are in-network for the specific plan you are considering — not just the insurer generally, and not just the metal tier. Networks vary by plan even within the same insurer. Source: HFMA, May 2026.
The subsidy system is more complex than it appears
ACA subsidies are advance payments based on projected income. If your actual income exceeds your estimate, you repay the difference at tax time — and since the return of the 400% FPL cliff in 2026, that repayment is uncapped. Self-employed individuals face additional complexity: their MAGI for subsidy purposes is calculated differently from W-2 employees and involves an IRS iterative worksheet when the health insurance deduction is also claimed. Many people receive the wrong subsidy amount because they use gross revenue instead of net MAGI. See our subsidy calculator for self-employed MAGI guidance.
What it is
Regulated health insurance sold on-exchange (healthcare.gov or state exchange) or off-exchange directly from a carrier
Who can enroll
US citizens and legal residents under 65 without affordable employer coverage, not on Medicare or Medicaid
Pre-existing conditions
Covered by law — cannot be denied or charged more
Subsidies
Available for incomes 100–400% FPL in 2026 ($15,650–$62,600 for a single adult)
Network
In-network restrictions apply — coverage for out-of-network care varies by plan type
Regulated by
Federal ACA law (PPACA) and state insurance departments
ACA plans are typically the best choice when
Income qualifies for subsidies (under $62,600 single) Pre-existing conditions need coverage Prescription drug coverage is important Mental health coverage needed Maternity coverage needed
2026 benchmark premiums — KFF.org
Texas (40-year-old, unsubsidized)
$661/mo
Florida
$683/mo
Tennessee
$711/mo
National average increase 2025→2026
+26%
Benchmark = second-lowest-cost silver plan. Age-adjusted — actual premium varies by age, county, and plan. Source: KFF.org.
What the benchmark premium means
The benchmark premium is the cost of the second-lowest-cost silver plan in your area. It is the reference point used to calculate your premium tax credit. Your actual premium depends on which plan tier and specific plan you choose — not all plans cost the same as the benchmark.
Plan tiers

Bronze, Silver, Gold, Platinum — what each tier means

ACA plans are grouped into four metal tiers that represent how costs are split between you and the insurer. The tier does not describe quality — it describes cost sharing. All four tiers must cover the same ten essential health benefits.

Tier Insurer pays You pay (avg) Monthly premium Best for
Bronze ~60% of costs ~40% — high deductible Lowest Healthy people who rarely use care and want low monthly premiums
Silver ~70% of costs ~30% — moderate deductible Moderate Most people — required for cost-sharing reductions (CSRs) if income under 250% FPL
Gold ~80% of costs ~20% — lower deductible Higher People who use care regularly and want predictable out-of-pocket costs
Platinum ~90% of costs ~10% — minimal cost sharing Highest People with high medical utilization or expensive prescriptions
Catastrophic Covers after high deductible Most costs until deductible met Very low Under 30 only, or hardship exemption — subsidies cannot be applied
2026 trend: shift from Silver to Bronze
ACA deductibles hit a record high of $3,786 in 2026 — up 37% from 2025. The primary driver was enrollees moving from Silver to Bronze plans to reduce monthly premiums after the enhanced subsidy expiration. Bronze plan enrollment rose from 30% to 40% of all marketplace selections. If you selected Bronze to lower your monthly cost, be aware that your out-of-pocket exposure in the event of illness is significantly higher than on a Silver plan. Source: KFF.org, May 2026.
Cost-sharing reductions (CSRs) — Silver plans only
If your household income is between 100% and 250% of FPL (up to $39,125 for a single adult in 2026), you may qualify for cost-sharing reductions that significantly lower your deductible, copays, and out-of-pocket maximum. CSRs are only available on Silver tier plans. If you qualify for CSRs, a Silver plan at a higher premium may cost you less overall than a Bronze plan with a much higher deductible. This is one of the most commonly misunderstood aspects of ACA plan selection.
The subsidy cliff — 2026

What happens when your income exceeds the subsidy threshold

The ACA premium tax credit is only available to households with incomes between 100% and 400% of the federal poverty level. Above 400% FPL, you pay the full unsubsidized benchmark premium — no partial credit, no phase-out. It is a hard cutoff.

This cliff returned on January 1, 2026 after the enhanced subsidies that temporarily removed it (2021–2025) expired. For a single adult earning just above $62,600, the difference between qualifying and not qualifying for a subsidy can be thousands of dollars per year.

The real cost above the cliff in 2026
The Urban Institute and Commonwealth Fund estimate the average annual premium for unsubsidized enrollees in 2026 is approximately $8,500 per year — up from around $4,400 in 2025. For a 40-year-old in Texas, the unsubsidized benchmark premium is $661/month ($7,932/year). For a 60-year-old in the same state, it is significantly higher due to age rating. Source: Urban Institute / Commonwealth Fund via CNBC, Feb 2026.

2026 subsidy cliff thresholds by household size

1 person
Subsidies available up to $62,600/year (400% FPL)
2 people
Subsidies available up to $84,600/year (400% FPL)
3 people
Subsidies available up to $106,600/year (400% FPL)
4 people
Subsidies available up to $128,600/year (400% FPL)
5 people
Subsidies available up to $150,600/year (400% FPL)

Based on 2025 HHS poverty guidelines, which apply to 2026 plan-year coverage per §36B(d)(3)(B). Source: IRS Rev. Proc. 2025-25.

Many self-employed individuals, freelancers, and early retirees whose income falls above these thresholds are now exploring Health Shares or other coverage types as a lower-cost alternative to paying full unsubsidized ACA premiums. See our coverage options overview or use the comparison tool to see how alternatives compare for your income level.

Subsidy cliff — single adult 2026
Income below $62,600 — subsidy available
Up to 9.96% of income
Income above $62,600 — no subsidy
$661+/mo full price (TX)
The maximum contribution percentage (9.96%) is from IRS Rev. Proc. 2025-25. Use the subsidy calculator for your specific income and household size.
2026 enrollment impact
27% of the drop in 2026 ACA sign-ups came from households with incomes between 400–500% FPL — the group most immediately affected by the cliff’s return. That group represented just 3% of 2025 enrollees but nearly half of the enrollment decline. Source: KFF.org, May 2026.
Enrollment windows

When you can enroll in an ACA plan

ACA marketplace enrollment is not open year-round. You can only enroll during Open Enrollment or if you experience a qualifying life event that triggers a Special Enrollment Period.

Nov 1
Open Enrollment begins. You can enroll in a new plan, switch plans, or renew existing coverage for the following year.
Dec 15
Deadline to enroll for coverage effective January 1. Plans selected after Dec 15 typically start February 1 or later.
Jan 15
Open Enrollment closes in most states. Some state-based marketplaces have extended deadlines — check your state’s exchange.
Year-round
Special Enrollment Period (SEP) if you experience a qualifying event: losing other coverage, getting married, having or adopting a child, moving to a new coverage area, or certain income changes.
Missing Open Enrollment
If you miss Open Enrollment and do not have a qualifying life event, you cannot enroll in an ACA plan until the next Open Enrollment period. Health shares, direct primary care, and other coverage types can be enrolled in at any time of year — which is one reason people above the subsidy cliff with an income change mid-year sometimes explore them. See all coverage options.
On-exchange vs. off-exchange

Should you buy through the marketplace or directly from a carrier?

ACA-compliant plans are sold two ways: through the official marketplace (on-exchange) or directly from an insurer (off-exchange). Both types must follow the same ACA rules — same ten essential health benefits, same pre-existing condition protections, same guaranteed issue requirements. The critical difference is subsidies — and plan availability.

On-exchange (marketplace)
healthcare.gov or state exchange
✓ Only way to receive the premium tax credit (APTC)
✓ Only way to receive cost-sharing reductions (Silver plans)
✓ Same ACA rules as off-exchange — identical essential benefits
✗ Requires income verification and reconciliation at tax time
✗ Advance credit overpayment must be repaid if income increases
✗ Plan selection limited to what the exchange lists for your county
Off-exchange (direct from carrier)
through insurer website or a licensed broker
✓ Same ACA rules — pre-existing, essential benefits, guaranteed issue
✓ No income reconciliation at tax time
✓ Access to plans not listed on the exchange — some carriers offer additional plan designs, broader networks, or lower deductibles exclusively off-exchange
✓ Same open enrollment and special enrollment period rules apply
✗ No premium tax credit — you pay the full premium
✗ No cost-sharing reductions on Silver plans
Off-exchange ACA plans — what most people don’t know
Off-exchange ACA plans carry the same legal protections as on-exchange plans. A Blue Cross plan bought directly from Blue Cross covers pre-existing conditions, includes all ten essential health benefits, and follows the same ACA rules as the identical plan sold on healthcare.gov — because it is the same plan under the same federal law. The only thing missing off-exchange is subsidy eligibility.

What many people don’t realize is that some insurers offer plans exclusively off-exchange — plan designs, network configurations, or benefit tiers that are not available through the official marketplace at all. In some counties, particularly in competitive urban markets, a carrier may offer a broader PPO network or a lower deductible structure off-exchange that simply doesn’t appear when you search healthcare.gov. A licensed broker who works both channels can show you the full picture — on-exchange options with subsidy applied alongside off-exchange options that might not be visible on the exchange.
The practical rule
If your income is between 100% and 400% FPL, buy on-exchange. The subsidy only applies there, and for most people in that range it reduces the monthly premium significantly. If your income is above 400% FPL, you pay full price either way — but going off-exchange removes the tax-time reconciliation obligation and opens access to plans not listed on the exchange. A licensed broker can compare both channels for your specific county and income. Use the comparison tool to see how ACA costs compare to other coverage types for your situation.
What about off-exchange non-ACA plans?
Some plans sold off-exchange are not ACA-compliant — short-term medical insurance, Health Shares, indemnity benefit plans, and MEC plans are sold outside the marketplace and do not follow ACA rules. They are different products with different coverage standards. This page covers ACA-compliant plans only. See the coverage options overview for a full comparison of all coverage types.

See how ACA plan costs compare to Health Shares and other alternatives for your income

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Common questions

ACA plans — questions people ask most

What is the difference between a marketplace plan and regular health insurance?
ACA plans are health insurance — they are simply insurance sold through a regulated exchange (healthcare.gov or a state marketplace) rather than directly from an insurer or through an employer. The regulatory requirements are stricter: marketplace plans must cover pre-existing conditions, include ten essential health benefits, and are eligible for premium tax credits. Insurance purchased outside the marketplace may not meet these requirements.
Will I pay back my subsidy if my income changes?
Possibly. ACA subsidies are advance payments based on your projected income. When you file your taxes, the IRS reconciles what you received against your actual income. If you earned more than projected, you repay the excess. If you earned less, you receive additional credit. Accuracy in projecting income is especially important in 2026 because the return of the 400% FPL cliff means even a modest income increase above the threshold results in losing the entire year’s subsidy — and repayment of advance credits is uncapped. Update your marketplace income estimate at healthcare.gov if your income changes significantly during the year.
What is the ACA subsidy cliff and how does it affect me in 2026?
The subsidy cliff is the income level above which ACA premium tax credits are not available. In 2026 it is 400% of the federal poverty level — $62,600 for a single adult. Above this income, you pay the full unsubsidized benchmark premium. The cliff returned January 1, 2026 after the enhanced tax credits that eliminated it from 2021 through 2025 expired. For someone just above the cliff, the difference between qualifying and not qualifying can be $5,000–$8,000 per year in premium costs.
Which metal tier should I choose?
It depends on how much care you use and your income. If your income is below 250% of FPL (under $39,125 for a single adult in 2026), a Silver plan may give you cost-sharing reductions that significantly lower your deductible and copays — making it cheaper overall than a Bronze plan even with a higher monthly premium. If you are healthy and rarely use care, a Bronze plan with a lower monthly premium may make sense. Gold and Platinum plans are best if you have significant ongoing medical needs or expensive prescriptions.
Can I use an ACA plan if I am self-employed?
Yes — and self-employed individuals are one of the primary target markets for ACA plans. If you work for yourself, you do not have access to employer-sponsored coverage, which is one of the main qualifying conditions for marketplace enrollment. Your eligibility for subsidies depends on your projected modified adjusted gross income (MAGI) for the year. Self-employed MAGI is more complex to calculate than W-2 income — it is based on net Schedule C profit, not gross revenue, and involves several above-the-line deductions. See the subsidy calculator for self-employed MAGI guidance.
What happens if I miss Open Enrollment?
If you miss Open Enrollment (November 1 to January 15) and do not have a qualifying life event, you cannot enroll in an ACA plan until the next Open Enrollment period. Qualifying life events include losing other coverage, getting married, having or adopting a child, moving to a new coverage area, or losing eligibility for Medicaid. If you need coverage outside of Open Enrollment and do not have a qualifying event, Health Shares and other coverage types can be enrolled in year-round.
What are ACA plan alternatives for people above the subsidy cliff?
People with household incomes above the 400% FPL threshold pay full unsubsidized ACA premiums, which in 2026 average around $8,500 per year nationally. Common alternatives include Health Sharing Ministries (Health Shares), direct primary care memberships paired with a Health Share, and indemnity benefit plans used as supplements. Each has different trade-offs around coverage, rules about pre-existing conditions, and out-of-pocket exposure. See the coverage options overview for a side-by-side comparison.