Obamacare Subsidy Calculator

Obamacare Subsidy Estimator

Estimate your potential monthly premium tax credit (subsidy) for health insurance purchased through the Affordable Care Act (ACA) marketplace.

This is typically the second-lowest cost Silver plan in your area. Use an estimate or find your local cost on healthcare.gov.

Understanding Obamacare Subsidies

The Affordable Care Act (ACA), often referred to as Obamacare, provides financial assistance in the form of premium tax credits (subsidies) to help eligible individuals and families afford health insurance purchased through the Health Insurance Marketplace (healthcare.gov or state-based exchanges).

How Subsidies Work

Subsidies reduce the amount you have to pay each month for your health insurance premium. They are designed to cap the percentage of your household income you're expected to contribute towards a benchmark health plan. If your chosen plan costs more than this capped amount, the subsidy covers the difference, up to the cost of the benchmark plan.

Eligibility Requirements

To be eligible for an ACA subsidy, you generally must meet the following criteria:

• Income: Your household income must be between 100% and 400% of the Federal Poverty Level (FPL) for your household size. However, with recent legislative changes (like the Inflation Reduction Act), the "subsidy cliff" at 400% FPL has been removed, meaning more people above 400% FPL may also qualify if their premiums would exceed 8.5% of their income.
• No Affordable Employer Coverage: You are not offered affordable health insurance through an employer (or a family member's employer) that meets minimum value standards.
• Not Eligible for Public Programs: You are not eligible for Medicare, Medicaid, or CHIP.
• Lawful Presence: You must be a U.S. citizen or lawfully present immigrant.

The Federal Poverty Level (FPL)

The FPL is a set of income thresholds used by the federal government to determine eligibility for various programs and benefits. It varies based on household size. Your income as a percentage of the FPL is a key factor in determining the amount of your subsidy. The lower your income relative to the FPL, the higher your potential subsidy.

The Benchmark Plan

Subsidies are calculated based on the cost of the "second-lowest cost Silver plan" available in your specific rating area (usually a county). This plan is known as the benchmark plan. The subsidy amount is the difference between the cost of this benchmark plan and the maximum amount you're expected to pay based on your income and FPL percentage. You can then use this subsidy to help pay for any Marketplace plan (Bronze, Silver, Gold, or Platinum), though it will go furthest if applied to a Silver plan or lower.

Limitations of This Calculator

This calculator provides an estimate based on general FPL guidelines and contribution rates. Actual subsidy amounts can vary significantly due to:

• Geographic Location: Benchmark plan costs differ by state, county, and even zip code.
• Age: Premiums, and thus benchmark plan costs, are generally higher for older individuals.
• Specific Plan Choices: While the subsidy is based on the benchmark plan, you can apply it to any metal-tier plan.
• Annual FPL Updates: FPL numbers and contribution rates are updated annually by the government.
• Tax Filing Status: Your tax filing status can impact household size and income calculations for ACA purposes.

For a precise subsidy determination, please visit healthcare.gov or your state's health insurance marketplace.

Example Scenarios

Let's look at a few examples using realistic numbers:

1. Single Individual, Moderate Income:
   • Annual Household Income: $35,000
   • Household Size: 1
   • Estimated Monthly Benchmark Plan Cost: $550
   • Result: (Based on 2024 FPL for 1 person: $14,580) This income is about 240% of FPL. The expected contribution rate might be around 5-6%. If the expected contribution is, say, 5.5% of income, that's ($35,000 * 0.055) / 12 = $160.42 per month. The subsidy would be $550 – $160.42 = $389.58 per month.
2. Family of Four, Lower Income:
   • Annual Household Income: $60,000
   • Household Size: 4
   • Estimated Monthly Benchmark Plan Cost: $1,200
   • Result: (Based on 2024 FPL for 4 people: $30,000) This income is exactly 200% of FPL. The expected contribution rate might be around 4%. If the expected contribution is 4% of income, that's ($60,000 * 0.04) / 12 = $200 per month. The subsidy would be $1,200 – $200 = $1,000 per month.
3. Couple, Higher Income (above 400% FPL):
   • Annual Household Income: $90,000
   • Household Size: 2
   • Estimated Monthly Benchmark Plan Cost: $800
   • Result: (Based on 2024 FPL for 2 people: $19,720) This income is about 456% of FPL. Under current rules, the expected contribution rate is capped at 8.5%. So, ($90,000 * 0.085) / 12 = $637.50 per month. The subsidy would be $800 – $637.50 = $162.50 per month. This demonstrates that even above 400% FPL, subsidies are possible if the benchmark plan cost exceeds 8.5% of income.

Your Estimated Monthly Subsidy: $" + monthlySubsidy.toFixed(2) + "

(Based on an annual household income of $" + householdIncome.toLocaleString() + ", household size of " + householdSize + ", and an estimated monthly benchmark plan cost of $" + benchmarkPlanCost.toFixed(2) + ".)