Where to enroll
New York runs its own ACA marketplace, NY State of Health, rather than using HealthCare.gov. Apply and enroll directly at NY State of Health.
Visit NY State of Health →ACA marketplace subsidies — 2026 plan year
New York ACA Subsidy Eligibility (2026)
Who qualifies for an ACA premium tax credit in New York, how the state's Medicaid expansion status affects eligibility, and what the 2026 reverted subsidy schedule means at common income levels.
See your exact numbers: Use the ACA Premium Tax Credit Calculator with your real household income, size, and benchmark plan premium.
Medicaid expansion status
New York has adopted the ACA's Medicaid expansion. Residents with household income below 138% of the Federal Poverty Level (FPL) generally qualify for Medicaid instead of a marketplace premium tax credit. Adults above the Medicaid limit and up to 200% FPL are covered by the Essential Plan, New York's Basic Health Program, instead of a premium tax credit; a household member eligible for it cannot claim the credit. Before July 1, 2026, the Essential Plan also covered incomes up to 250% FPL, so a 2026 row above 200% FPL describes the months after that date.
2026 subsidy schedule — the 400% FPL cliff
The enhanced (IRA-era) premium tax credit expired December 31, 2025 and was not extended by OBBBA. For the 2026 plan year, ACA subsidies revert to the pre-2021 schedule: a hard cliff at 400% of the Federal Poverty Level — no premium tax credit at all above it — and required-contribution percentages rising to about 9.96% of income just below the cliff, per IRS Rev. Proc. 2025-25.
Household of 1 — New York 2026 examples
| % of FPL | Household income | Status | Expected contribution |
|---|---|---|---|
| 150% | $23,475/yr | The Essential Plan (Basic Health Program, no PTC) | — |
| 200% | $31,300/yr | The Essential Plan (Basic Health Program, no PTC) | — |
| 250% | $39,125/yr | PTC-eligible (8.44% of income) | $3,302/yr |
| 300% | $46,950/yr | PTC-eligible (9.96% of income) | $4,676/yr |
| 400% | $62,600/yr | PTC-eligible (9.96% of income) | $6,235/yr |
Illustrative only — uses the 2025 HHS poverty guideline for household size 1 in New York's region and the 2026 plan year's reverted applicable-percentage schedule. Actual credits depend on your exact income, benchmark Silver plan premium, and filing status — use the calculator above for your own numbers.
Household of 4 — New York 2026 examples
| % of FPL | Household income | Status | Expected contribution |
|---|---|---|---|
| 150% | $48,225/yr | The Essential Plan (Basic Health Program, no PTC) | — |
| 200% | $64,300/yr | The Essential Plan (Basic Health Program, no PTC) | — |
| 250% | $80,375/yr | PTC-eligible (8.44% of income) | $6,784/yr |
| 300% | $96,450/yr | PTC-eligible (9.96% of income) | $9,606/yr |
| 400% | $128,600/yr | PTC-eligible (9.96% of income) | $12,809/yr |
Illustrative only — uses the 2025 HHS poverty guideline for household size 4 in New York's region and the 2026 plan year's reverted applicable-percentage schedule. Actual credits depend on your exact income, benchmark Silver plan premium, and filing status — use the calculator above for your own numbers.
Frequently asked questions
Where do I enroll in ACA marketplace coverage in New York?
New York runs its own ACA marketplace, NY State of Health, rather than using HealthCare.gov. Apply and enroll directly at NY State of Health.
Has New York expanded Medicaid?
New York has adopted the ACA's Medicaid expansion. Residents with household income below 138% of the Federal Poverty Level (FPL) generally qualify for Medicaid instead of a marketplace premium tax credit. Adults above the Medicaid limit and up to 200% FPL are covered by the Essential Plan, New York's Basic Health Program, instead of a premium tax credit; a household member eligible for it cannot claim the credit. Before July 1, 2026, the Essential Plan also covered incomes up to 250% FPL, so a 2026 row above 200% FPL describes the months after that date.
What is the ACA subsidy cliff for the 2026 plan year?
The enhanced (IRA-era) premium tax credit expired December 31, 2025. For the 2026 plan year, subsidies revert to the pre-2021 schedule: a hard cliff at 400% FPL (no premium tax credit at all above it) and required-contribution percentages up to about 9.96% of income, per IRS Rev. Proc. 2025-25.
When is ACA open enrollment for New York?
New York sets its own open enrollment window through NY State of Health. For comparison, CMS lists HealthCare.gov's 2027 window as November 1, 2026 through January 15, 2027. Check NY State of Health for New York's exact dates.
Sources
- IRS — Premium Tax Credit
- IRS Form 8962 — Premium Tax Credit
- HHS — Federal Poverty Guidelines
- HealthCare.gov — The Marketplace in Your State
- CMS — Marketplace 2026 Open Enrollment Period Report: National Snapshot (state-by-state platform table)
- KFF — State Health Insurance Marketplace Types
- KFF — Status of State Medicaid Expansion Decisions
- CMS — Plan Year 2027 Marketplace Plans and Prices Fact Sheet
Related insights
Use these guides for rule explanations, planning context, and follow-up questions beyond the calculator result.
Related Calculators
ACA Premium Tax Credit
Marketplace health insurance subsidy + cost-sharing reduction
Federal Poverty Level Calculator
Convert household income to a 2026 FPL percentage and compare common program thresholds
Federal Poverty Level 2026
2026 HHS poverty guidelines by household size and region, common percentage multiples, and which year ACA uses
Medicaid Income Limits 2026
Check Medicaid income limits by state — 138% FPL expansion threshold, non-expansion parent limits, and the coverage gap
HSA Calculator
$4,400/$8,750 triple tax advantage, HDHP, post-65 stealth IRA
Whatever your state charges, get a reminder before each federal tax deadline. One email before each quarterly estimated tax payment (Tax Day included), plus one when the IRS publishes next year's numbers. About five a year; you confirm once and can unsubscribe anytime.
Emails are sent with Kit. See our privacy policy.