$84,600 is the key 2026 cutoff for married ACA enrollees in most states: earn more than 400% of the federal poverty level and federal premium subsidies generally disappear.
The cliff returned after enhanced premium tax credits expired at the end of 2025, so households that took advance subsidies may have to repay them if their annual income comes in too high.
Older adults not yet on Medicare, especially self-employed people or those without workplace coverage, could be hit hardest, with some facing annual premiums above $20,000.
Tax advisers say households just over the line may lower modified adjusted gross income through HSA, IRA or retirement contributions, while self-employed families may also deduct health premiums and half of self-employment taxes.