11/29/2025
Do you have health insurance through the Marketplace?
Do you get an Advanced Premium Tax Credit (APTC) that helps lower your monthly premium?
Things are about to change and if you said yes to either of these questions, there are things you *need* to know.
Currently, anyone who is over 400% of the Federal Poverty Level, or FPL, is going to have ZERO tax credit, no help. Full. Price. Premiums. This could make for a big shock when renewing your plan. This is an awful change and will hurt so many people, especially families. But it's not the only change, in my opinion there's another change you need to be even more aware of, because this one can sneak up on you. 2025 and previous years there's been a "repayment cap" or a max someone can have to pay back when reconciling income after receiving an Advanced Premium Tax Credit. In 2026 there won't be a cap.
Example: you're a family of 4 who makes a total of $115,000 per year. In 2025 you would have received a $350 tax credit that made it possible for you to have a $1200 deductible, 20% coinsurance at roughly $900/m.
You head into 2026 expecting to make the same amount of money. You now qualify for a $340 tax credit and the most similar plan with the same carrier will cost you roughly $1400/m.
All your other bills are going up, now you need to bring in more money, so you grab all the overtime or find another job. Your income goes from your expected $115k to $130k. You file your taxes. Your APTC went from $340 to $0 You now owe $340x12 or just over $4000 when you go to file your taxes. Thats twice as much as you would have owed in a previous year.
The premium increases will be tough enough, don't mess around with your income this upcoming year, know your numbers and update the marketplace if they change.
Federal Poverty Level varies based on family size, check your numbers at the link. 2026 numbers aren't out yet but you can get a feel for how they increase and what they were in 2025.
Learn about the Federal Poverty Level (FPL) by reviewing the definition in the HealthCare.gov Glossary.