2025-2026 Analysis

ACA Subsidy Calculator

Calculate Premium Tax Credits for 2025-2026. Compare enhanced subsidies vs the 400% FPL cliff, plan Roth conversions, and project healthcare costs through Medicare eligibility.

2025 vs 2026 cliff Roth conversion impact Medicare bridge Income optimization
Key Features 2025
  • Compare 2025 enhanced vs 2026 cliff scenarios.
  • Plan Roth conversion ladder with subsidy impact.
  • Project subsidies from age 50 to Medicare at 65.
  • Calculate combined marginal rate on conversions.
  • Check eligibility for Cost Sharing Reductions.
  • See additional subsidies from 10 states.

Understanding ACA Premium Tax Credits

The Affordable Care Act provides Premium Tax Credits (PTC) to help households between 100-400% of the Federal Poverty Level afford health insurance. The American Rescue Plan Act (ARPA) temporarily enhanced these subsidies through 2025, removing the 400% FPL "cliff" and extending help to higher incomes.

Critical for 2026: Unless Congress acts, enhanced subsidies expire after 2025. The 400% FPL cliff returns, meaning households above this threshold receive zero subsidy—a potential loss of $10,000-$25,000+ per year. This calculator helps you compare both scenarios and plan your income strategy accordingly.

Key ACA Subsidy Concepts

Federal Poverty Level (FPL)

The income threshold used to determine subsidy eligibility. For 2025: $15,650 for individual, +$5,500 per additional person.

400% FPL (2025): $62,600 single, $129,000 family of 4

Second Lowest Cost Silver Plan (SLCSP)

The benchmark plan used to calculate your subsidy. Subsidies equal the SLCSP premium minus your expected contribution.

Formula: PTC = SLCSP - (MAGI × Applicable %)

Cost Sharing Reductions (CSR)

Extra benefits on Silver plans for 100-250% FPL households. Lower deductibles, copays, and out-of-pocket maximums.

Best value: 100-150% FPL gets 94% actuarial value (~$500 deductible)

ACA MAGI

Modified AGI including non-taxable Social Security, tax-exempt interest, and foreign earned income. Roth distributions are NOT included.

Planning tip: Build Roth assets before retirement for tax-free, MAGI-free income

2026 Cliff Warning for Early Retirees

If enhanced subsidies expire, a couple at 401% FPL (~$84,000) would lose their entire subsidy—potentially $15,000-$20,000 per year in healthcare costs. Plan Roth conversions and income timing carefully around the 400% FPL threshold.