Affordable Care Act (ACA) Subsidy Calculator
Calculate your potential eligibility for premium tax credits (subsidies) to lower your health insurance costs.
(You can find this information on healthcare.gov or your state's marketplace website)
2024
2025
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
Understanding ACA Subsidies
The Affordable Care Act (ACA), often referred to as Obamacare, provides financial assistance to individuals and families who purchase health insurance through the Health Insurance Marketplace. This assistance comes in the form of Premium Tax Credits (PTCs), commonly known as subsidies, which reduce the amount you pay for your monthly health insurance premiums.
How Eligibility is Determined
Eligibility for ACA subsidies is primarily determined by your Modified Adjusted Gross Income (MAGI) and your household size, relative to the Federal Poverty Line (FPL) for your state. Generally, if your household income falls between 100% and 400% of the FPL, you may qualify for a subsidy.
The Calculation Logic (Simplified)
The ACA subsidy calculation involves several steps:
- Determine Household Income (MAGI): This is usually your Adjusted Gross Income (AGI) plus any non-taxable Social Security benefits and certain other income exclusions.
- Determine Household Size: This includes you, your spouse, and any dependents you claim on your tax return.
- Find the Federal Poverty Line (FPL): The Department of Health and Human Services (HHS) publishes poverty guidelines annually, which vary by state (for Alaska and Hawaii) and household size.
- Calculate the Expected Contribution Percentage: The ACA sets a sliding scale for how much a household is expected to contribute to their health insurance premiums. For a given year, a household with MAGI at the FPL level is expected to contribute a certain percentage of their income, and this percentage increases linearly up to 400% FPL. For example, in 2024, the expected contribution for a household at 150% FPL was 2%, and it rose to 8.5% at 400% FPL.
- Calculate the Affordable Premium: Multiply your household income by the expected contribution percentage. This gives you the maximum amount your household is expected to pay for a benchmark health insurance plan.
- Determine the Benchmark Plan Premium: The Marketplace uses the second-lowest cost Silver plan (SLCSP) in your area as the benchmark for subsidy calculations.
- Calculate the Premium Tax Credit (Subsidy): The subsidy amount is the difference between the benchmark plan's premium and your calculated affordable premium. If your affordable premium is less than the benchmark plan's cost, you'll receive the difference as a subsidy.
Important Considerations:
- Income Fluctuations: If your income changes significantly during the year, you should report this to the Marketplace to adjust your subsidy.
- Employer-Sponsored Insurance: If you are offered affordable, minimum value employer-sponsored health coverage, you are generally NOT eligible for Marketplace subsidies, even if your income would otherwise qualify.
- Medicaid/CHIP: If your income is below 138% of the FPL (or a similar threshold depending on your state's Medicaid expansion status), you may be eligible for Medicaid or the Children's Health Insurance Program (CHIP) instead of Marketplace subsidies.
- "Wealth Cliff" Relief: For years 2020-2025, the subsidy eligibility has been expanded to include those earning more than 400% FPL, effectively capping premiums at 8.5% of household income. This calculator reflects this change.
- State Variations: While federal guidelines exist, some states operate their own marketplaces with slightly different rules or benchmark plans. The FPL figures are crucial and can be found on official government websites.
This calculator provides an estimate based on the information you provide. For definitive eligibility and subsidy amounts, please visit Healthcare.gov or your state's official health insurance marketplace website.
";
resultHTML += "
";
resultDiv.style.backgroundColor = "#ffc107"; // Warning yellow for potential Medicaid eligibility
} else if (expectedContributionRate === 0 && householdIncome > 0) {
// This case is unlikely with the current fplContributionRates logic unless federalPovertyLine is zero, which is validated.
// It could represent a scenario below the lowest defined FPL threshold for subsidies.
resultHTML += "Eligibility Summary
"; resultHTML += "Your household income is below 100% of the Federal Poverty Line (FPL)."; resultHTML += "You may be eligible for Medicaid or CHIP in your state, rather than Marketplace subsidies."; resultHTML += "Estimated Monthly Subsidy: $0"; resultHTML += "";
resultHTML += "
";
resultDiv.style.backgroundColor = "#dc3545"; // Danger red for no subsidy
}
else {
resultHTML += "Eligibility Summary
"; resultHTML += "Your income level does not appear to qualify for premium tax credits based on standard calculations."; resultHTML += "Estimated Monthly Subsidy: $0"; resultHTML += "";
resultHTML += "
";
resultDiv.style.backgroundColor = "#28a745"; // Success Green
}
// Add note about income cliff relief
if (fplPercent >= 100 && fplPercent <= 400) {
resultDiv.innerHTML += "Note: For coverage years 2020-2025, premium tax credits are capped at 8.5% of household income for those earning above 400% FPL, meaning subsidies are available to more people.";
}
resultDiv.innerHTML = resultHTML;
}
Eligibility Summary
"; resultHTML += "Based on your inputs:"; resultHTML += "- ";
resultHTML += "
- Household Income: $" + householdIncome.toLocaleString() + " "; resultHTML += "
- Household Size: " + householdSize + " "; resultHTML += "
- Your Income as % of FPL: " + fplPercent.toFixed(1) + "% "; resultHTML += "
- Benchmark Silver Plan Premium (Est.): $" + benchmarkPremium.toLocaleString('en-US', { minimumFractionDigits: 2, maximumFractionDigits: 2 }) + " / month "; resultHTML += "
- Your Expected Monthly Contribution: $" + affordablePremium.toLocaleString('en-US', { minimumFractionDigits: 2, maximumFractionDigits: 2 }) + " "; resultHTML += "