How is the ACA subsidy calculated?

The Marketplace caps what you pay for the second-lowest Silver plan (the 'benchmark') at a percentage of your household income, based on the Federal Poverty Level. Through 2025, that cap is 0% at the lowest incomes and 8.5% at the top — anything above that is paid as a premium tax credit.

What income do I use for the ACA subsidy estimate?

Use your expected Modified Adjusted Gross Income (MAGI) for the coverage year — wages, self-employment income, interest, dividends, and most retirement distributions. The Marketplace reconciles the final subsidy on your tax return.

Who counts as part of my household for ACA subsidies?

Your tax household: you, your spouse if filing jointly, and anyone you claim as a tax dependent. Roommates and partners you don't claim as dependents are separate households.

Is this calculator the same as the official Marketplace estimate?

No — our tool gives a quick estimate based on Federal Poverty Level brackets. Your final eligibility and credit amount are determined by HealthCare.gov when you complete an application.

TXInsurance.com

ACA Subsidy Calculator

Estimate where your household lands on the 2026 Federal Poverty Level (FPL) and whether you qualify for ACA premium tax credits. Final eligibility is determined by the Marketplace.

Quick answerThrough 2026, the ACA premium tax credit caps what Texas households pay for the benchmark Silver plan at 0%–8.5% of income, depending on where you fall on the Federal Poverty Level. Enter your household size and expected MAGI below to estimate your subsidy in 60 seconds.

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No subsidy? Over 400% FPL?

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Household income (MAGI)

Household sizeState

100% FPL (your household)

$21,150

Your income

$45,000

Income as % of FPL

213%

0%100%400% (cliff)500%+

Texas has NOT expanded Medicaid for adults

No Medicaid for most adults below 100% FPL

You likely qualify for premium tax credits (APTC). At 213% FPL, your expected contribution toward the benchmark silver plan is about 7.26% of income under the official 2027 table (IRS Rev. Proc. 2026-26) — the rest becomes a subsidy. Households under 250% FPL also qualify for cost-sharing reduction (CSR) silver plans with lower deductibles and copays.

Estimate only. Uses the 2026 HHS poverty guidelines and the official 2027 applicable percentage table (IRS Rev. Proc. 2026-26) for plan year 2027. Final eligibility is determined by the Marketplace using verified MAGI.

Want a broker to walk you through it? Call 800-214-8976 / 281-747-9800 or book a call.

*Some ACA plans in some areas have a small one-time enrollment fee due to little or no broker compensation. Agency enrollment fees never apply to Medicare products.

Frequently asked questions

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