Self-Employed and Losing My Marketplace Subsidies in 2026? Here’s What to Do Next
If you’re self-employed and staring at a renewal notice that made your stomach drop, you’re not alone. A lot of freelancers, 1099 contractors, consultants, real estate professionals, and small business owners run into the same surprise: your Marketplace premium jumps dramatically when you lose (or no longer qualify for) subsidies. Not to mention there was a flat increase in premiums around 18-25 percent depending on your state and the marketplace plan this year.
Maybe your income went up. Maybe your household situation changed. Maybe you’re having a strong business year (good news!) but it pushed you out of the subsidy range (not-so-fun news). Whatever the reason, the result can feel the same: you’re suddenly paying full price—and full-price Marketplace plans, especially Silver plans, can be painfully expensive.
The good news: losing your subsidies does not mean you’re out of options. In fact, many self-employed people and small business owners explore off-exchange health insurance plans (plans outside the Marketplace), especially when they’re healthy and mainly want strong protection without overpaying.
This guide breaks down:
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Why Marketplace premiums spike when subsidies go away
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What you should do immediately if you’re self-employed and losing your subsidies
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How off-exchange, underwritten plans work
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How this ties into small business health insurance options
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When an off-exchange plan may cost close to half of a full-price Silver Marketplace plan (for those who qualify)
Table of Contents
Why Your Marketplace Premium Jumps When You Lose Subsidies
Marketplace subsidies (premium tax credits) are designed to lower your monthly premium based on your estimated household income and household size. When your income increases—even for good reasons like landing a new contract or having a profitable year—your subsidy can decrease or disappear.
So what happens next?
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You’re no longer getting help to cover the premium
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You now see the true full-price cost of the plan
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Silver plans (and sometimes Gold) can be especially costly in many areas
That’s why someone might pay a “reasonable” amount during the year, and then suddenly face a renewal that’s hundreds (or even more) higher per month.
If you’re thinking, “I didn’t realize I was getting that much help,” you’re not alone. It happens constantly in the self-employed world because income fluctuates.
Step 1: Confirm Whether You’re Actually Losing Subsidies
Before you panic-cancel your plan, do this:
Update your Marketplace application
Log in and update:
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Estimated income for next year
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Household changes (marriage, divorce, dependents)
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Any changes in job status (self-employed, part-time, etc.)
Sometimes people “lose subsidies” simply because their info wasn’t updated and the Marketplace is defaulting to a higher number.
Understand the difference between:
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Losing subsidies (paying full price)
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Owing money back at tax time (if income was underestimated)
If your income was higher than you estimated, you may owe some subsidy back. That’s a separate issue from what you pay monthly moving forward.
Step 2: Decide What You Actually Need From Health Insurance
When people search “Self employed and losing my subsidies on marketplace,” what they usually mean is:
“I want quality coverage, but I can’t justify paying full price for a Marketplace plan anymore.”
So ask yourself these questions:
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Do you want a plan mainly for big emergencies (catastrophic protection)?
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Do you want predictable copays for doctor visits and prescriptions?
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Do you travel often or want a broader network?
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Do you have doctors you must keep?
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Are you generally healthy, with no major medical conditions?
That last question matters a lot because it determines whether underwritten off-exchange plans are a realistic option.
What Are Off-Exchange Health Insurance Plans?
Off-exchange plans are plans purchased outside the Marketplace. Some are ACA-compliant (depending on the plan type and state rules), and many alternatives marketed to self-employed people are medically underwritten.
Medically underwritten means:
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You apply for coverage
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You answer health questions (and sometimes provide medical history)
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The carrier decides whether to approve you
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Approval typically requires being healthy enough, with no major health conditions
This is a key difference from Marketplace plans, which are guaranteed issue (you can’t be denied for health reasons).
The Big Trade-Off: Guaranteed Issue vs Underwriting
Let’s be super clear (because this is the part most people misunderstand):
Marketplace (On-Exchange)
Pros
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Cannot be denied for health reasons
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Covers essential health benefits
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Pre-existing conditions are covered
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Subsidies available if you qualify
Cons
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Full price can be very expensive without subsidies
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Networks can be restrictive in some areas
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Deductibles can be high, especially for the premium you’re paying
Off-Exchange Underwritten Plans
Pros
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If you qualify, premiums can be much lower
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Many self-employed people use them as a cost-effective alternative
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Often designed for healthier individuals who want strong protection
Cons
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You must be healthy enough to get approved
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Not ideal if you have major ongoing conditions
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Plan structures vary, so comparing is important
Why Underwritten Off-Exchange Plans Can Be Much Cheaper
If you’re asking, “How can an off-exchange plan cost less?” the short answer is:
Risk pooling.
Marketplace plans must accept everyone, including people with high ongoing medical costs. Underwritten plans filter for healthier applicants, which can lower the overall claims risk and reduce monthly premiums.
That’s why, for someone who qualifies, an off-exchange underwritten plan can often be close to half the cost of a full-price Silver Marketplace plan.
Not always. Not everywhere. But it’s common enough that it’s absolutely worth exploring if you’re healthy and losing subsidies.
Who Typically Qualifies for Underwritten Plans?
You’re more likely to qualify if you:
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Are generally healthy
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Have no major chronic conditions (like uncontrolled diabetes, serious heart disease, certain autoimmune conditions, active cancer treatment, etc.)
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Have not had major recent surgeries or hospitalizations
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Aren’t currently dealing with expensive ongoing care needs
Every carrier is different, and underwriting guidelines can vary, which is why working with a broker is helpful. A broker can quickly tell you whether you’re likely to qualify and which options fit your situation.
How This Connects to Small Business Health Insurance
A lot of people assume “small business health insurance” means a traditional group plan with multiple employees. But in reality, many small businesses are:
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Husband-and-wife businesses
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Self-employed individuals with a side LLC
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One-person S Corps
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Small teams of 2–10 employees
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1099-heavy businesses (contractor model)
Depending on your business structure, there may be multiple approaches to coverage:
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Individual coverage (Marketplace or off-exchange)
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Private/off-exchange options designed for self-employed individuals
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Group coverage (for businesses that qualify and want a group plan)
If you’re self-employed and losing subsidies, you may be thinking:
“Do I need small business health insurance… or just the best individual plan?”
The right answer depends on:
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Number of employees (W-2 vs contractors)
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Budget and desired employer contribution
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Whether you want one plan for everyone or flexible options
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Your health profile (especially if underwriting is being considered)
Why Working With a Broker Matters (Especially When You’re Losing Subsidies)
When you lose Marketplace subsidies, the “default” move is often:
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Keep your Marketplace plan
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Pay full price
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Hope it gets better next year
But a broker can help you compare:
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Staying on-exchange at full price
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Switching to a different Marketplace plan with better value
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Exploring off-exchange underwritten plans for healthier applicants
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Evaluating small business health insurance strategies if you have employees
A brokerage like My Private Health Insurance specializes in helping self-employed people and small business owners explore these alternatives. We will connect you with a licensed agent in your state and they will go over all your options.
What to Expect When Applying for an Underwritten Off-Exchange Plan
If you decide to look at off-exchange underwritten options, the process usually looks like this:
1) Quick intake and needs analysis
You’ll discuss:
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Your budget
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Your preferred doctors/network needs
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Your ideal deductible and max out-of-pocket comfort zone
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Whether you need prescriptions covered (and how)
2) Health questionnaire (underwriting)
You’ll answer questions about:
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Current conditions
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Medications
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Past surgeries
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Hospitalizations
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Ongoing treatments
3) Approval or alternative path
If you’re approved, you’ll receive plan options and pricing.
If you’re not approved, then the broker can pivot to Marketplace options or other strategies.
This is why it’s so important to understand upfront:
these off-exchange plans are underwritten, and you must be healthy enough to qualify.
Real-World Scenario: The “I’m Doing Well… and Now I’m Paying for It” Problem
This is one of the most common self-employed stories:
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You had a strong year in business
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Your income increased
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Your subsidy dropped or disappeared
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Your Silver plan renewal looks outrageous
At that point, many people realize:
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They don’t want to downgrade coverage just to afford the premium
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They don’t want to keep paying full price for a plan they barely use
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They want to explore an alternative that matches their actual risk and needs
That’s where off-exchange underwritten plans can become a serious option—especially when you’re healthy and simply want smart, cost-effective protection.
When It Makes Sense to Stay on the Marketplace
Even if you’re losing subsidies, staying on-exchange can still be the best move if:
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You have major health conditions or expensive prescriptions
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You want guaranteed ACA coverage with no underwriting
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You want the certainty of essential health benefits and standardized protections
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You’re anticipating major planned medical care next year
In those cases, the Marketplace may be more expensive, but it can also be more appropriate.
When It Makes Sense to Explore Off-Exchange Underwritten Plans
Exploring underwritten options can make sense if:
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You’re self-employed and healthy
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You’re losing subsidies and facing full-price premiums
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You want an option that may be significantly more affordable
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You’re comfortable with an application process that includes health questions
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You want help comparing plan designs and networks
For many who qualify, the savings can be meaningful—sometimes close to half the cost of a full-price Silver Marketplace plan—which is why it’s a conversation worth having.
Next Steps: How to Compare Options Without Guessing
If you’re self-employed and losing your Marketplace subsidies, here’s a simple plan:
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Update your Marketplace application so you know your real full-price cost
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List your must-haves (doctors, prescriptions, deductible comfort)
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Compare full-price Marketplace plans (not just the one you currently have)
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Explore off-exchange underwritten options if you’re healthy enough to qualify
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If you have employees or a spouse in the business, evaluate small business health insurance strategies
To explore off-exchange underwritten plan options with a broker, you can request quotes through My Private Health Insurance at www.myprivatehealthinsurance.com.
Bottom Line
Losing your Marketplace subsidies can feel like a penalty for having a good year—especially when you’re self-employed. But it can also be a turning point where you finally compare the real market of options.
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Marketplace plans are guaranteed issue (no health denial), but full price can be expensive.
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Off-exchange plans that are underwritten require that you be healthy enough to get approved with no major health conditions.
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If you can qualify, those underwritten plans can often be close to half the cost of a full-price Silver Marketplace plan, making them a powerful option for many self-employed individuals and small business owners.
If you want help comparing options, including underwritten off-exchange coverage and small business health insurance approaches, start at www.myprivatehealthinsurance.com and request a comparison.