2026 ACA Rules & Data
Estimate your income-change scenario
Estimate how changes in household income could affect your Marketplace premium tax credit. Use an official benchmark premium from your Marketplace preview for a more useful planning comparison.
Estimate your income-change scenario
This version uses the 2026 IRS applicable-percentage rules and the applicable FPL vintage for 2026 coverage. Enter the benchmark premium shown by your Marketplace or leave it blank for an income-only screening result.
Estimated result
What is the ACA subsidy cliff?
For 2026 coverage, the premium tax credit uses a sliding contribution schedule tied to household income as a percentage of the applicable federal poverty line. A household above the applicable 400% boundary may lose eligibility under the standard rule, but the amount of any change depends on the benchmark Silver premium, household details, filing status, and other eligibility conditions. That is why this tool shows a planning comparison instead of promising a final subsidy.
How this 2026 estimate works
The tool compares the entered MAGI values with the applicable FPL for household size, applies the 2026 IRS applicable-percentage table, and first attempts an official CMS Marketplace benchmark lookup from ZIP, state, household size, ages, and MAGI. If the lookup is unavailable, the advanced manual benchmark option remains available. The conceptual estimate is the lesser of the enrollment premium and the benchmark premium minus the household contribution, bounded at zero. Actual Marketplace and tax calculations include additional rules and monthly reconciliation.
Why location and household details matter
The applicable benchmark plan varies by rating area and coverage family. ZIP code, county, ages, tobacco rating, plan availability, and Marketplace type can affect the actual premium. The federal Marketplace and state-based Marketplaces also publish and manage data differently. ToolVerse therefore labels this page as a planning estimate and sends users to the official Marketplace for final verification.
Employer coverage and other eligibility guardrails
Affordable employer-sponsored minimum-value coverage, Medicaid/CHIP, Medicare, TRICARE, dependent status, lawful-presence rules, and filing status can change or eliminate eligibility. If any screening flag is selected, the result explains that the income-only comparison may not apply. Married filing separately has limited exceptions that this calculator does not adjudicate.
2026 repayment and income-change warning
The IRS states that for tax years after 2025, there is no repayment cap on excess advance Premium Tax Credit: if advance payments exceed the allowable credit, the total difference may be reconciled on the tax return. Update the Marketplace when income or household circumstances change and keep records for Form 8962. This is educational information, not tax advice.
Methodology and limitations
Rules year: 2026. FPL vintage: the applicable vintage for 2026 Marketplace coverage, resolved from IRS timing guidance rather than automatically using the 2026 HHS table. Premium data: the page first requests a benchmark from the protected ToolVerse CMS proxy for supported federal-platform scenarios. If the proxy is unavailable or the state is state-based, no premium is fabricated; the advanced manual option requires an official Marketplace value. The page does not expose credentials or determine official eligibility.
Questions people ask
Does this tell me whether I qualify?
No. It provides an estimate based on the information entered. The Marketplace determines eligibility and final prices after considering the full application and available plans.
Why do I need a benchmark premium?
The Premium Tax Credit depends on the applicable benchmark Silver plan for the relevant location and coverage family. A national average cannot safely substitute for that plan-specific value.
What if my employer offers health coverage?
Employer coverage can affect Premium Tax Credit eligibility when it is affordable and provides minimum value. This tool flags the possibility but does not make the official employer-coverage determination.
What happens if my income changes?
The advance credit estimate and final credit can differ when projected income or household circumstances change. Report changes to the Marketplace as soon as possible and reconcile the credit as required.
Sources and data notes
- IRS Revenue Procedure 2025-25 — 2026 applicable-percentage table and required-contribution percentage.
- IRS Form 8962 instructions — PTC, household income, coverage family, enrollment premium, applicable SLCSP, and reconciliation concepts.
- IRS Premium Tax Credit Q&A — eligibility, employer coverage, income changes, and repayment guidance.
- HHS ASPE Poverty Guidelines API — official FPL tables and vintage references.
- CMS Marketplace types for Plan Year 2026 — federal, SBE-FP, and state-based Marketplace structure.
- CMS Marketplace API documentation — official API capabilities, plan search, eligibility estimates, and API-key requirements.
Sources are referenced for methodology only. ToolVerse is independent and does not imply endorsement, partnership, or affiliation.