Do I Qualify for ACA Subsidies in 2027? Income Limits and What to Do If You Don’t
"Do I qualify for subsidies?" is the first question almost every client asks me heading into open enrollment, and for 2027 the answer got more complicated. The enhanced subsidies expired, the old income limits are back, and the 400% poverty level cliff is hard-edged again.
Here's how to figure out where you land — and exactly what to do if the answer is no.
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The Quick Test: Find Your Number
Premium tax credits for 2027 are based on your estimated 2027 modified adjusted gross income (MAGI) compared to the 2026 federal poverty guidelines. The magic number is 400% of poverty for your household size. Above it: no subsidy. Below it: you may qualify, with larger credits at lower incomes.
The 400% cutoffs for 2027 coverage:
- Single person: $63,840
- Household of 2: $86,560
- Household of 4: $132,000
If your MAGI is under your household's number, you likely qualify for at least some premium tax credit. If it's over, you don't — and neither does anyone else in your tax household shopping on the marketplace.
A few things people get wrong about this test:
It's household income, not individual. Married filing jointly? Both incomes count. A 22-year-old on your tax return? Their income counts too.
It's MAGI, not gross pay. Modified adjusted gross income starts with your AGI and adds back a few things like non-taxable Social Security. For most people it's close to the AGI on your tax return — but "close to" isn't "equal to" on the boundary.
It's an estimate of next year. You're attesting to what you expect to earn in 2027, not what you earned in 2026.
If You're Under the Limit: What to Expect
Good news first: if you qualify, the underlying ACA subsidy structure is still intact. Lower-income households still get substantial credits, and cost-sharing reductions are still available on Silver plans for those under 250% of poverty.
What's changed is that the extra help is gone. The enhanced subsidies did two big things: they beefed up credits for people already eligible, and they extended some help above 400% of poverty. Both are expired for 2027. So even qualifying households will generally see smaller credits than they got in 2025.
If You're Over the Limit: Your Real Options
So the test came back negative. Now what? You have more choices than most people realize.
Pay full price on the marketplace. The default. Your plan, your doctors, your network — just without the monthly credit. This is worth doing if someone in your household has health conditions that make guaranteed-issue ACA coverage valuable. Price it as your baseline, then compare everything else against it.
Shop private off-exchange plans. This is the move most over-the-limit households don't know exists. Private, medically underwritten health insurance sold outside the marketplace is built for exactly your situation. These private off-exchange PPO plans usually cost almost half as much as a full-price marketplace plan with no subsidies, as long as there are no major health conditions. Many come with nationwide PPO networks.
I want to be straight about the tradeoff: these plans require you to qualify medically. Applicants generally need to be in relatively good health, and these are not ACA plans — they don't include guaranteed issue or the ACA's pre-existing condition protections. But for a healthy household that just lost subsidies, the savings versus full-price marketplace coverage are often dramatic.
Consider a Bronze marketplace plan. If you want to stay in the ACA system, Bronze cuts the monthly cost significantly in exchange for higher out-of-pocket exposure — a legitimate strategy for healthy people who mainly want catastrophic protection.
Look at the rest of your household's options. A spouse's employer plan, COBRA from a recent job change — open enrollment season often overlaps across these, so compare them all in the same week rather than deciding in isolation.
The Gray Zone: When You're Close to the Line
Some households land within a few thousand dollars of their cutoff, and that's where planning actually pays off. Legitimate ways to reduce MAGI include:
- Pre-tax retirement contributions — 401(k), SEP-IRA, or SIMPLE IRA contributions lower your AGI dollar for dollar
- HSA contributions — if you have qualifying high-deductible coverage, 2027 limits are $4,500 self-only or $9,000 for family coverage, plus $1,000 extra if you're 55 or older
- Self-employed business deductions — the half of self-employment tax you deduct, plus ordinary business expenses
Here's the critical warning for 2027: the safety net for bad estimates is gone. Starting with the 2026 tax year, the caps that used to limit excess subsidy repayment are eliminated. Underestimate your income and end up over the cliff, and you could owe back every dollar of advance credit you received. When in doubt, estimate slightly high — or talk to your tax professional first.
Don't Forget the Calendar
None of this matters if you miss the window. Open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027, with a December 15, 2026 deadline for coverage starting January 1. After January 15, you're locked out of the marketplace until next fall unless you have a qualifying life event.
Private off-exchange plans, worth noting, aren't bound by that calendar — you can apply any time of year. But shopping everything side by side during open enrollment is still the smart play, because that's when you can compare all your options with real 2027 prices in front of you.
The Bottom Line
Qualifying for 2027 subsidies comes down to one comparison: your estimated MAGI versus 400% of poverty for your household size. Under it, you get help (though less than before). Over it, you're shopping at full price — and that's exactly when private off-exchange plans deserve a serious look.
Get a free quote at myprivatehealthinsurance.com or call 561-927-9469. Tell us your household size and income ballpark, and we'll tell you straight whether subsidies are in play for you — and what your private-plan alternatives look like if they're not.
Justin Brain is a licensed health insurance agent (licensed since 2016, National Producer Number (NPN) #17940663) and founder of My Private Health Insurance in Fort Lauderdale, Florida. He has helped self-employed professionals, 1099 contractors, and small business owners in 33 states secure private, off-exchange health coverage — often at about half the cost of full-price marketplace plans. His team specializes in medically underwritten PPO plans for people who earn too much for ACA subsidies.