Will I Still Qualify for Health Insurance Subsidies in 2026?

Utah Avenue Insurance
12 minutes ago
3 min read

As we look ahead to 2026, many families are wondering if they’ll still qualify for subsidies to help pay for their health insurance on the Marketplace. Congress is still deciding whether families who earn above certain income limits will continue to qualify for financial help under the current rules. With the potential expiration of expanded subsidies under the American Rescue Plan (ARP) and the Inflation Reduction Act (IRA), it’s more important than ever to understand how eligibility works—and what you can do now to prepare.

What Is the Federal Poverty Level (FPL)?

The Federal Poverty Level (FPL) is the income guideline used to determine eligibility for subsidies on the Marketplace. It’s based on your household size and income, and it changes each year. If Congress doesn’t extend the ARP or IRA, only households with incomes between 100% and 400% of the FPL will qualify for subsidies in 2026. Anyone earning below 100% or above 400% will not be eligible for any help toward their monthly premium.

For 2025, the FPL income amounts look like this:

Household Size	100% FPL	400% FPL
1 person	$15,060	$60,240
2 people	$20,440	$81,760
3 people	$25,820	$103,280
4 people	$31,200	$124,800
5 people	$36,580	$146,320
6 people	$41,960	$167,840
7 people	$47,340	$189,360
8 people	$52,720	$210,880

For each additional family member you include in your taxable household you would add $5380 to the 100% column and $21,520 to the 400% column. These amounts are updated annually, so the numbers for 2026 will likely go up slightly. However, the government won’t finalize those new numbers until later this year.

If you want to be notified when the new numbers are released for 2026, contact a local agent at Utah Avenue Insurance. We can contact you and go over your best options for health insurance based on your estimated income for 2026.

What Happens If You’re Close to the 400% Line?

If your income is close to the 400% threshold, it’s critical to monitor your income carefully. In past years, if you went even $1 over 400% of the FPL, you would lose all subsidy eligibility—this is what’s referred to as the “subsidy cliff.” If ARP and IRA are not extended, this rule could return in 2026. This means that you will need to pay back all the subsidies you got on your health plan at tax time which can easily exceed $10,000.

If your income is on the edge, consider the following:

Track your year-to-date income monthly.
Set a budget to avoid surprise increases.
Talk to your tax advisor or bookkeeper before making big financial decisions.
Consider a private health plan where the price is not dependent on your income.

What If You’re Between 300%–350% of the FPL?

Households in this range need to pay extra close attention. These families currently receive generous subsidies, but if the cliff returns, they’re also the most at risk of falling off it. A small bonus, inheritance, or a spouse taking a new part time job can easily put your income over the 400% threshold.

If you're self-employed, estimating your income can be tricky. A good bookkeeper can help you:

Accurately project year-end income.
Time major business purchases strategically.
Decide whether to invest in equipment this year or wait until the next to maximize deductions.

Even a small change in income could have a big impact on what you pay for your health insurance.

Stay Informed and Get Help

At Utah Avenue Insurance, we’re watching this situation closely. If Congress does not act, the subsidy cliff could be back in 2026—and we want you to be prepared.

If you want to be in the know and have someone keeping an eye on your plan and income situation, we’re here for you. Our local agents can: