An ACA subsidy calculator built on the rules in force for the coverage year

The temporary enhanced credits that applied from 2021 through 2025 expired at the end of 2025. Under current law, households with income above 400% of the federal poverty line get no premium tax credit for 2026 coverage, and the expected share of income is higher at every level. The calculator applies those rules.

The calculator uses the HHS poverty guidelines and the IRS applicable percentage tables for the coverage year selected: IRS Rev. Proc. 2025-25 for 2026 coverage and IRS Rev. Proc. 2026-26 for 2027 coverage. Under the 2027 table, the highest expected contribution is 10.22% of household income, for households between 300% and 400% of the poverty line (IRS Rev. Proc. 2026-26).

For 2026 coverage, Marketplaces use the 2025 HHS poverty guidelines. 400% of the 2025 guideline for one person in the 48 contiguous states and DC is $62,600 (HHS poverty guidelines, 2025). A single filer one dollar above that figure gets no credit under current law.

If Congress changes the law, results will differ, and the calculator's disclaimer says so. Tell your clients the same thing, and avoid promising that any credit will be restored or continued.

It works out household income as a percentage of the poverty line for the household size and location, finds the applicable percentage for that income, and multiplies it by income to get the expected yearly contribution. The monthly credit is the benchmark silver premium minus one-twelfth of that contribution, never more than the chosen plan's premium.

Income as a percentage of the poverty line is rounded down to a whole number, as Form 8962 does, and the applicable percentage rises in a straight line within each income band. Results show the monthly and annual credit, the net monthly premium, income as a percentage of the poverty line, the required contribution percentage and the expected yearly contribution.

It does not check eligibility. Offers of affordable employer coverage, immigration status and Medicaid eligibility are outside the model, and households below 100% of the poverty line generally do not qualify for the credit. Advance payments are reconciled on the tax return with IRS Form 8962 (opens in a new tab), and a household whose income comes in higher may have to repay some or all of the advance credit.

• Inputs: coverage year, location, household size, household MAGI, benchmark silver premium, premium of the chosen plan
• Outputs: monthly and annual premium tax credit, net monthly premium, income as % of poverty line, required contribution
• Not checked: employer coverage offers, immigration status, Medicaid or CHIP eligibility, cost-sharing reductions

Individual and family health agencies that enroll clients in Marketplace coverage, particularly those serving self-employed people, early retirees under 65 and households with variable income. Those clients are most exposed to the 400% limit and most likely to search for a subsidy estimate before contacting anyone.

Early retirees are a natural audience: they often control their income through retirement account withdrawals, and an estimate shows how much income timing matters. Point them to a tax professional for the tax side; your role is the coverage.

Agencies with Spanish-speaking or other multilingual clients benefit from the calculator interface running in 2 languages: English, Spanish, Simplified Chinese, Korean, Vietnamese and Arabic. Pair the calculator with consent language, in each language you serve, that covers how you follow up.

Marketplace enrollment has its own agent rules on top of state licensing. Agents assisting through the federal platform must be registered with the Marketplace and document the consumer's consent before helping, and state-based Marketplaces set their own certification requirements. The calculator lead is a starting point, not authorization to act on someone's account.

CMS has tightened oversight of unauthorized enrollments and plan switches. Use the lead to arrange a conversation, obtain and record the consumer's consent the way current CMS rules require, and confirm details directly with the consumer before submitting anything. Check current CMS agent and broker guidance each plan year.

Prospects will also want to compare plans on total cost, not just premium. The health plan cost comparison calculator lets them weigh deductibles and out-of-pocket maximums once they know their net premium.