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
- HealthCare.gov -- Welcome to the Health Insurance Marketplace
- HealthCare.gov -- Dates and Deadlines
- healthinsurance.org -- ACA Open Enrollment 2026 Guide
- KFF -- 8 Things to Watch for 2026 ACA Open Enrollment
- AARP -- Open Enrollment: Getting Marketplace Health Insurance for 2026
- Families USA -- What Consumers Need to Know About ACA Coverage for 2026
- Congress.gov -- Enhanced Premium Tax Credit and 2026 Exchange Premiums FAQ
- healthinsurance.org -- Will You Receive an ACA Premium Subsidy?
- KFF -- ACA Enhanced Premium Tax Credit Calculator
- CMS -- Marketplace 2026 Open Enrollment Fact Sheet
- Kitces.com -- Reducing ACA Premiums After Enhanced PTC Expiration