How to Get Obamacare (ACA): Cost, Who Qualifies & How to Apply
Dongni Chen is a licensed health insurance agent who speaks Mandarin and Cantonese, and can help you compare plans and enroll in Chinese. Open Enrollment for 2027 coverage starts on November 1, 2026.
For 2027 coverage | Information compiled in October 2026. If policies change, follow the official announcements.
Key points
- Open Enrollment for 2027 coverage starts on November 1, 2026. In states using the federal marketplace, HealthCare.gov, it ends on January 15, 2027. States with their own marketplaces may have different deadlines. Apply early if you want coverage to start on January 1 (see the dates below).
- Your health does not affect your premium. You can enroll if you have a chronic condition or a history of illness, and the price is the same.
- Federal subsidies have returned to the old rules. The enhanced subsidies available in 2021–2025 ended at the end of 2025 and have not been extended. For 2027, households with income above 400% of the federal poverty level do not qualify for federal subsidies.
- Starting in 2027, fewer immigration statuses qualify for subsidies. People with work visas, student visas, refugee or asylum status, TPS and certain other statuses can still buy coverage in 2027, but cannot receive subsidies.
1. What is Obamacare?
Obamacare is the common name for individual health insurance under the Affordable Care Act (ACA). Individuals and families can buy health insurance through a government health insurance marketplace:
- Many states: HealthCare.gov, the federal marketplace.
- Some states have their own marketplaces, with dates and procedures that may differ.
All ACA plans must cover essential health services, such as outpatient care, emergency care, hospitalization, prescription drugs, maternity care and mental health care.
2. Who can enroll?
You generally need to meet all of these conditions:
- Live in the state where you are applying.
- Be a US citizen or lawfully present in the United States. People with lawful status, including green cards, work visas and student visas, can enroll.
- Not currently be incarcerated.
Being able to buy coverage does not mean you qualify for a subsidy. These are explained separately below.
3. Who qualifies for a subsidy?
The subsidy is formally called the Premium Tax Credit. It can be applied directly to your premium each month. For 2027 coverage, you generally need to meet these conditions:
1. Your income is within the range
Household income generally needs to be between 100% and 400% of the federal poverty level. For 2027 coverage, the calculation uses the 2026 poverty guidelines:
| Household size | 100% (lower federal subsidy limit) | About 138% (Medicaid reference level in most states) | 400% (upper federal subsidy limit) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
These guidelines apply to the 48 contiguous states and Washington, DC. Alaska and Hawaii have higher guidelines. Medicaid uses the guidelines for the year you apply and monthly income; the amounts in this table are only a reference.
What counts as income? Your expected household income for all of 2027: adjusted gross income on your tax return, plus foreign earned income excluded from tax, tax-exempt interest and nontaxable Social Security benefits. Your household generally includes you, your spouse and your tax dependents.
2. Your status qualifies (major changes starting in 2027)
Under the federal law passed in 2025 (H.R. 1), starting with 2027 coverage, only the following groups can receive subsidies:
- US citizens.
- Green card holders (lawful permanent residents).
- A few special categories: Cuban/Haitian entrants and COFA migrants from Pacific island nations.
People with the following statuses can still buy coverage starting in 2027, but cannot receive subsidies and must pay full price: Work visas, student visas, refugee status, asylum or pending asylum, TPS (Temporary Protected Status), U visas, T visas, and other humanitarian or temporary lawful statuses.
Also, starting in 2026, lawfully present immigrants with income below 100% of the poverty level who cannot get Medicaid because of their immigration status can no longer receive subsidies either.
If you plan to apply for a green card, immigration rules are complicated. Consider consulting a qualified immigration attorney first.
3. You do not have other qualifying coverage
- Your employer offers affordable coverage: For 2027, the employee's own share of the premium must be no more than 10.22% of household income, and the coverage must meet minimum standards. If it does, you generally cannot receive an ACA subsidy.
- You already have Medicare or Medicaid: You generally cannot also receive a subsidy.
4. You must file taxes
If you receive a subsidy, you must file a tax return the following year. The marketplace will send you Form 1095-A, which you use to complete Form 8962 when filing. This reconciles the subsidy paid in advance each month with the amount you qualify for based on your actual income. If you received too little, the difference is added to your tax refund; if you received too much, you must pay it back.
Married people must generally file Married Filing Jointly to receive subsidies. Filing separately does not qualify, except in cases of domestic abuse or spousal abandonment.
4. How much does it cost?
What affects your premium?
- Age: Older people pay more.
- Where you live: Prices vary by area.
- How many family members enroll.
- Which plan tier you choose.
- Smoking: Some states allow higher premiums for tobacco users.
Your premium does not depend on your health, medical history or sex.
How is the subsidy calculated?
The government first determines how much you are expected to pay. The subsidy covers the difference:
Subsidy = benchmark plan premium − your expected contribution
The benchmark is the second-lowest-cost Silver plan in your area. Your expected contribution is based on a percentage of income. For 2027:
| Income as a percentage of the poverty level | Annual contribution as a percentage of income |
|---|---|
| Under 133% | 2.15% |
| 133% – 150% | 3.23% – 4.30% |
| 150% – 200% | 4.30% – 6.78% |
| 200% – 250% | 6.78% – 8.66% |
| 250% – 300% | 8.66% – 10.22% |
| 300% – 400% | 10.22% |
| Over 400% | No federal subsidy |
Source: IRS Rev. Proc. 2026-26.
Two examples (for illustration only; actual amounts depend on local prices):
- A family of 4 expects $82,500 in income for 2027, about 250% of the poverty level. Their contribution is 8.66% of income, about $7,145 a year or $595 a month. If their local benchmark Silver plan costs $1,800 a month for the family, the subsidy is about $1,205 a month.
- A single person expects $47,880 in income for 2027, about 300% of the poverty level. Their contribution is 10.22%, about $4,893 a year or $408 a month. If the local benchmark plan costs less than $408 a month, there is no subsidy.
You can use the subsidy for any Bronze, Silver, Gold or Platinum plan. Choose a plan cheaper than the benchmark and you pay less; choose a more expensive one and you pay the difference.
State subsidies: Some states offer additional subsidies. Check your state's rules.
How do you choose a plan tier?
| Tier | Approximate share paid by the insurer | What to expect |
|---|---|---|
| Bronze | 60% | Lower monthly premiums, more to pay when you get care |
| Silver | 70% | People with lower incomes can reduce their out-of-pocket costs by choosing Silver |
| Gold | 80% | Higher monthly premiums, less to pay when you get care |
| Platinum | 90% | Highest monthly premiums, lowest out-of-pocket costs |
These percentages are averages, not the percentage paid for every visit.
People with income below 250% of the poverty level who choose a Silver plan can also get Cost-Sharing Reductions, with much lower deductibles and copays than a standard Silver plan.
Estimate your income carefully
Starting with tax year 2026, there is no repayment cap on excess subsidies. If you underestimate your income and your actual income ends up higher, you must repay all the excess subsidy when you file taxes. If your income changes, update your application promptly.
5. When can you enroll?
Open Enrollment for 2027 coverage
States using the federal marketplace, HealthCare.gov:
| Starts | For coverage starting January 1 | Ends |
|---|---|---|
| November 1, 2026 | Choose a plan by December 15, 2026 | January 15, 2027 |
Dates may differ in states with their own marketplaces. See Obamacare Open Enrollment 2027: start date and deadlines by state for state dates.
Missed the deadline? Special Enrollment Periods
After Open Enrollment, you generally need a qualifying life event to enroll, usually within 60 days of the event. Examples include:
- Losing your previous coverage, such as leaving a job, the end of employer coverage or the end of Medicaid.
- Moving to a new area.
- Marriage, childbirth or adoption.
- Gaining a new lawful immigration status.
You can apply for Medicaid year-round.
6. Other things to know
- With a low income, you may qualify for Medicaid directly: In most states, the adult income threshold is about 138% of the poverty level.
- Some states have a penalty for being uninsured. Check your state's rules.
7. How do you apply?
- Gather your documents: Family members' identification, such as passports or green cards; Social Security numbers, if available; expected 2027 income information, such as pay stubs and tax returns; and details of current coverage.
- Estimate your 2027 income: This is key to determining your subsidy.
- Compare plans: Check monthly premiums, deductibles, hospital and doctor networks, and coverage for medicines you take regularly.
- After choosing a plan, pay the first month's premium for coverage to take effect.
You can apply through the official website yourself or ask a licensed insurance agent for help. The premium is the same as applying on your own through the official website, with no extra charge for using an agent.
Questions? Contact Dongni Chen
If you are unsure whether you or a family member can enroll, how much subsidy you may qualify for or which tier to choose, contact me and I can help you review your options.
Subsidies and eligibility are subject to the marketplace's review.
Main sources: HealthCare.gov; state health insurance marketplace websites; IRS Rev. Proc. 2026-26; HHS 2026 poverty guidelines.
More ACA guides
- US Health Insurance System Explained: Universal Healthcare? Employer, Obamacare, Medicaid & Medicare
- How Does Health Insurance Work? Deductible vs Out-of-Pocket Maximum, Copay vs Coinsurance
- Obamacare Income Limits 2027: Who Gets Subsidies & When Premiums Are $0
- Health Insurance for Immigrants: Green Card, H-1B & F-1 – Who Can Get Obamacare in 2027
- Unemployed Health Insurance: COBRA vs Obamacare After Losing Your Job
- Obamacare Open Enrollment 2027: Start Date & Deadlines by State
- Missed Open Enrollment? Special Enrollment Period & Qualifying Life Events