If you’re shopping for health insurance off the exchange this year, you may have noticed premiums rising sharply. Without careful planning, these higher costs could also leave you facing a hefty tax bill next year.
At the beginning of the year, the enhanced premium tax credits subsidies designed to lower Affordable Care Act (ACA) premiums came to an end.
Originally introduced in 2021, these temporary subsidies helped reduce health insurance costs for individuals earning above 400% of the federal poverty level (FPL). In 2025, that threshold is about $62,600 for single filers, meaning many households now face significantly higher premiums without the extra financial support.
For many individuals, earning just above the subsidy threshold means losing access to Affordable Care Act premium tax credits. This creates a difficult situation where full-price health insurance premiums feel unaffordable, leading some to go uninsured or underinsured. Understanding your available options is crucial to avoid falling into this coverage gap and to protect yourself from unexpected medical costs.
Individuals whose modified adjusted gross income (MAGI) exceeds 400% of the federal poverty level face what is known as the “subsidy cliff.” As Carolyn McClanahan, a certified financial planner and founder of Life Planning Partners, explains, even one dollar above the threshold eliminates eligibility for the tax credit.
According to estimates from KFF, a nonprofit health policy organization, someone earning $64,000 just above the threshold would pay $14,931 in total premiums. In contrast, individuals earning between 100% and 400% of the federal poverty level remain eligible for premium tax credits. For example, a person with an income of $62,000 would pay only $6,175, highlighting the sharp financial difference created by the subsidy cliff.
You can receive the Affordable Care Act premium tax credit in advance or claim the full amount when filing your tax return. Eligibility is based on your estimated modified adjusted gross income (MAGI) for the coverage year, with the credit deducted directly from monthly premiums.
MAGI includes adjusted gross income from IRS Form 1040, nontaxable Social Security benefits, tax-exempt interest such as municipal bonds, and untaxed foreign income. Overestimating MAGI can lead to repayment of part or all of the credit when filing taxes. Experts advise monitoring your income closely in 2026 to avoid crossing the 400% threshold.
Financial planners recommend strategies like contributing to a health savings account or traditional 401(k), since contributions reduce taxable income. Reviewing your investment portfolio is also key selling investments at a loss allows you to deduct up to $3,000, a method known as tax-loss harvesting. These steps can help maintain eligibility for ACA premium tax credits and lower overall health insurance costs.
The Affordable Care Act subsidy cliff means that earning just above 400% of the federal poverty level can eliminate premium tax credits entirely, leaving individuals with much higher health insurance costs. Careful income management, strategic tax planning, and awareness of available deductions can help you avoid losing subsidies and keep premiums affordable.