ACA marketplace enrollment

The Affordable Care Act (ACA) Marketplace, also known as the Health Insurance Marketplace or "Obamacare," is the primary way for individuals and families without employer-sponsored coverage to purchase health insurance. Plans are sold through healthcare.gov (the federal exchange) or state-based exchanges, and many enrollees qualify for premium tax credits that reduce monthly costs.

21 steps across 6 sections

1. Federal Exchange

  • Visit healthcare.gov
  • Create an account or log in
  • Complete an application with income and household information
  • Compare plans and select coverage
  • Pay your first premium to activate coverage

2. State-Based Exchanges

  • 18+ states run their own exchanges with separate websites
  • Examples: Covered California, NY State of Health, Connect for Health Colorado, Get Covered Illinois (new for 2026)
  • Same plan categories and subsidy rules apply

3. Getting Help

  • Visit healthcare.gov/find-assistance for local in-person help
  • Call the Marketplace Call Center: 1-800-318-2596
  • Licensed brokers and navigators can assist at no extra cost

4. 2026 Changes -- Major Shift

  • The 400% FPL income cap ("subsidy cliff") is back — earn $1 over and you get zero subsidy
  • Average subsidized enrollees who paid ~$888/year in 2025 now face ~$1,904/year in 2026 (more than double)
  • Insurers raised premiums ~18-26% on average for 2026

5. Income Limits for 2026

  • Below 100% FPL: May qualify for Medicaid (in expansion states) but not marketplace subsidies
  • 100-400% FPL: Eligible for premium tax credits on a sliding scale
  • Above 400% FPL: No subsidy available (the cliff is back in 2026)

6. How the Credit is Calculated

  • Based on the cost of the second-lowest-cost Silver plan (benchmark plan) in your area
  • You pay a percentage of income (ranging from ~2% at 100% FPL to ~8.5% at 400% FPL) toward the benchmark premium
  • The government pays the difference as a tax credit
  • Income measured by Modified Adjusted Gross Income (MAGI): wages, gig income, investments, etc.

Common Mistakes

  • Not enrolling during open enrollment
  • Choosing the cheapest premium
  • Underestimating or overestimating income
  • Not checking if your doctors are in-network
  • Ignoring Silver plan CSRs

Pro Tips

  • Always shop and compare
  • Check the "Silver loading" effect
  • Use the healthcare.gov window shopping tool
  • Report income accurately
  • Consider total cost of care

Sources

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