Couples earning greater than $85K in the household income and individuals earning more than $63K are in jeopardy of losing all current subsidies.
Yes, the changes for 2026 are now inevitable for Marketplace, that is ObamaCare subsidies are changing significantly for plan year 2026. This will not be very good news for literally millions throughout the US, and certainly tens of thousands for those right here in Louisiana, me included. What most persons are unaware of that we have been in a “Covid 19” enhanced subsidies pattern for the past five years, yes that’s right, for the past half decade the calculations have been different than the original ten years of Obamacare. Just for the record, these changes are not due to the new “One Big, Beautiful Bill” just recently signed by President Trump. These are changes that have been coming due to an “expiring” of certain “enhanced subsidies” that was extended through the end of 2025 in the passing of the “Inflation Reduction Act” passed in August of 2022. Originally, these “enhanced subsidies” were supposed to expire at the end of 2022 and was originally designed to coincide with the ongoing Covid pandemic. Most of us would likely agree that Covid has been over with for quite some time, and the financial effects have since been mitigated.
| Household Number | 400% of US Federal Poverty Level for 2025 (these rates will likely be adjusted for inflation for 2026) |
| 1 | $62,600 |
| 2 | $84,600 |
| 3 | $106,600 |
| 4 | $128,800 |
| 5 | $150,600 |
The Affordable Care Act (ACA), better known as “ObamaCare” was signed into law on March 23rd, 2010. Yes, believe it or not it’s been the law of the land in regard to health coverage for more than 15 years! Originally, it had set out to assist those falling between 100% and 400% of FPL (Federal Poverty Level). So, if you earned greater than 400% in household income, then ObamaCare subsidies were not available to you and your household. And many states, including Louisiana, had expanded their Medicaid roles by adopting the Medicaid Expansion Option under the ACA, which raised the Medicaid qualifications up to 138% of the FPL. So, many individuals earning less than $21,597 are not eligible for subsidies, but in many cases may be eligible for Louisiana Medicaid. We’ll talk about the effects on Medicaid coming from the Big Beautiful Bill in a future article.
So, if you feel like your Household Income may be greater than the new 400% FPL threshold for the planned year 2026, then you definitely want to be aware and be prepared for these changes coming. Yes, we will explore options just like we did in the first 10 years of ObamaCare. I will continue to keep the door open as a health agent, and explore other alternatives for my clients, namely Short-Term Medical plans that may be for many their very best option. Currently STM Plans are relegated to only 4-month policies. Allstate Health Solutions as a carrier of STM policies, are working on a workaround that will allow for up to a full one-year policy, hopefully coming soon, maybe as soon as August-September. Also, it is quite likely that the 4-month regulation limit will soon be reversed and again extended to a minimum of a full one-year policy, and maybe as much as 3-year policy durations.
Here’s the bottom-line, keep in touch, be aware of the changes that are coming, and let’s get prepared for the best 2026 we can have!