2023 Obamacare Subsidy Chart and Calculator

Subsidies, or premium tax credits, are based on three things: Your income, the list price of the benchmark plan, and how much the Affordable Care Act requires you to pay toward your health insurance.

The actual subsidy is the difference between the benchmark plan and your expected contribution.

You have to make a reasonable estimate of how much you’ll make in advance since you generally apply for coverage before the year starts.

You also have to compare the total plan premium and your household income before coverage starts.

The American Rescue Plan Act (ARP) of 2021 and Inflation Reduction (IRA) of 2022 improved the affordability of the Affordable Care Act (ACA).

How? In three major ways:

First: There is no longer a Federal Poverty Level (FPL) income cap requirement. Previously, if you earned more than 400% FPL, you didn’t qualify for any subsidies. Now, the benchmark Silver plan costs no more than 8.5% of your annual household income, no matter how high that income is. The subsidies still eventually drop off to nothing, but they taper off gradually instead of ending the moment your income hits 400% FPL.

Second: The amount of subsidies for those who earn less than 400% FPL has increased.

Prior to 2021, you were expected to spend from around 2% to 9.83% of your household income toward health insurance.

That range has dropped to 0% to 8.5%.

Third: Anyone who received or was approved for unemployment benefits can enroll in a free- (or low-cost), low-deductible health plan after the enhanced federal subsidies.

In October 2022, the Biden administration also fixed the so-called “family glitch,” which blocked family members of people with employer plans from obtaining subsidies. Federal officials expect the number of individuals with subsidized ACA plans to rise by about 1 million.

The federal government has stated that average premiums dropped on average about $30 per person per month and median deductibles dropped by 90%, from $450 to just $50/year.

How Much You Pay for a Benchmark Silver Plan

Source: Internal Revenue Service. 26 CFR 601.105. irs.gov. Accessed October 2022, U.S. Congress.

Households with more than 8 people should add $4,720 per person.

In most states, those who make up to 138% of the federal poverty level qualify for Medicaid eligibility instead of ACA exchange subsidies.

In 2022, for a single person, 138% of the poverty level equates to $18,754; for a family of four, that amount equals $38,295.

Alaska and Hawaii are unique states with higher income guidelines – those can be found here.

This information applies to health insurance plans that cover you and your family during 2023.

ACA subsidies are available to reduce your monthly payments or as a credit for next year’s tax filing with the IRS.

New federal poverty level income levels are released annually in January. Those numbers are used immediately to determine eligibility for Medicaid and the Children’s Health Insurance Program (also known as CHIP). They are also used in November when the ACA Open Enrollment Period begins.

The right income to submit is your modified adjusted gross income or MAGI (basically, the annual income you report on your tax return, with a few tweaks).

You can still “get Obamacare” no matter how much you make per year. You simply won’t qualify for monthly premium assistance if you make more than the income limit.

Less Than 100% of FPL: If your household makes less than 100% of the federal poverty level, you don’t qualify for premium tax credits (“Obamacare subsidies”). However, in most states, you’re probably eligible for Medicaid. To learn more, it’s important to apply directly to your state’s Medicaid program.

2022 Total Household Income for Minimum ACA Subsidy

If You Don’t Qualify: If your household makes too much to qualify for a subsidy, you can also consider off-Marketplace insurance.

These plans are generally identical to subsidy-eligible plans, generally cost the same, and follow ACA rules.

In some states, you’ll be able to find off-exchange ACA-compliant Silver plans which are identical to their on-exchange counterparts but which have a lower unsubsidized price, via a pricing strategy called “Silver Loading”. There’s a long, strange story behind why this is the case, but the bottom line is that those who don’t qualify for financial subsidies might find some Silver plans off-exchange which cost less than their on-exchange counterparts.

Depending on the area, you may also find that different insurers offer plans outside the exchange, giving you more options from which to choose.

Under the 2021 American Rescue Plan and 2022 Inflation Reduction Act, individuals earning up to 150% FPL can enroll in a Silver benchmark plan for $0 with dramatically reduced deductibles and other out-of pocket expenses. Previously, no matter how low-income you were, people had to contribute something toward the cost of the benchmark Silver plan.

If you received unemployment benefits or were approved for them at any point during 2022, you also qualify for the expanded subsidies through the federal Health Insurance Marketplace.

On the other end of the spectrum, people who make more than 400% FPL can also qualify for a premium subsidy. In the past anyone making more than the income cap was unable to qualify and would have to pay full-price whether on or off the exchange.