Chapter 10 · 6 min read
If You Can't Afford Coverage
About 80% of people who buy on the ACA marketplace qualify for a premium tax credit. Most young adults qualify and don't realize it. Here's how to find out.
Who qualifies for a subsidy?
Through 2025, the income cap was effectively removed — most people earning under about $60,000 get meaningful help. Even higher incomes get something if premiums are more than 8.5% of your income. Always apply. The marketplace calculates your subsidy automatically based on your estimated income.
Medicaid — possibly free coverage
If you earn under about 138% of the federal poverty level (~$20,000/year for a single person in 2025), you likely qualify for Medicaid. In states that expanded Medicaid, it's free or nearly free. The marketplace will route you automatically when you apply.
Tip
If you're earning hourly and your income fluctuates, estimate your annual income honestly. The marketplace reconciles at tax time — if you under-estimated, you might owe some subsidy back; if you over-estimated, you get a refund.
What if you don't qualify for help and still can't afford it?
- Pick a Bronze or HDHP plan to minimize the premium — the worst-case max is still capped.
- Look into community health centers (sliding scale based on income).
- Talk to a guide — they can spot subsidies and programs you'd never find on your own.