Note: This is an update to a popular post from the last two years on some of the FI subs. There is always a good amount of commentary over the function of the ACA and the morality of subsidies for FIRE'd folks. While I am fine with having those discussions, people might want to read the comments made in previous years. I will put links to my 2024/2025 posts below for anyone that wants to explore those comments for background.
Special disclaimer for 2026: Everything in this post assumes that Congress does not extend the COVID subsidy enhancements and that the default ACA subsidy rules return for 2026.
Anyone can now see the 2026 prices and plans in their area with some anonymous data (age/zip/income/etc) in about three minutes at https://www.healthcare.gov/see-plans/#/. If you have a local state-run exchange, then you'll be redirected. State exchanges all update on their own schedule, so 2026 prices may or may not be live just yet.
For those who may not be familiar with the ACA, below is an actual real-world example of what being leanFIRE'd or controlling your MAGI can do to minimize healthcare costs in early retirement. The prices below are for a married couple with an average age of 52 and with MAGI under 133% of the Federal Poverty Level (FPL), which qualifies us for the maximum possible amount of ACA subsidies from both the premium tax credit (PTC) subsidy system and cost-sharing reduction (CSR) subsidy system. We have three dependent children as well, one of which will be on our ACA policy, and we live in a non-expansion state, so expansion Medicaid does not apply to us.
Keep in mind that the premiums below would be much higher for a couple if they were in their 60s rather than in their 40s/50s like us. Tobacco users can expect to pay up to 50% additional premium on top of the age-rating. If we were both 62, then the unsubsidized Bronze premium below would rise from $19,140 to $27,168. Prices also can vary incredibly between states. If we were both 62 and living in West Virginia instead of Texas, then our Bronze premium would rise from $27,168 to $49,584. If instead we were living in Minnesota, then our Bronze premium would fall from $27,168 to $21,696.
I have also included the policy options we would likely take if we were either eligible only for premium subsides and not also cost-sharing reductions, as well as the plan we would likely take if we were ineligible for any subsidies at all. People who are over 200% FPL should generally avoid Silver plans due to the way states have elected to deal with the loss of federal funding for the cost-sharing reduction subsidy system, so while I have provided the full market price of our Silver plan, please note that almost nobody would want to ever buy that plan at that price as better Bronze and Gold options are available.
Our 2026 Silver plan with subsidies and cost-sharing reductions (based purely on MAGI):
- $84 in annual premium
- $0/$0 deductible (individual/family)
- $0 PCP
- $10 specialist
- $5 urgent care
- $0/$15 tier1/tier2 scripts
- 25% ER coinsurance
- $2,200/$4,400 MaxOOP (individual/family)
Our 2026 Silver plan without subsidies and cost-sharing reductions (full market price):
- $26,892 in annual premium
- $6,000/$12,000 deductible (individual/family)
- $40 PCP
- $80 specialist
- $60 urgent care
- $20/$40 tier1/tier2 scripts
- 40% ER coinsurance
- $8,900/$17,800 MaxOOP (individual/family)
The 2026 Gold plan we would pick if our MAGI was just above 200% FPL (no meaningful CSRs):
- $2,952 in annual premium
- $2,000/$4,000 deductible (individual/family)
- $30 PCP
- $60 specialist
- $45 urgent care
- $15/$30 tier1/tier2 scripts
- 25% ER coinsurance
- $8,200/$16,400 MaxOOP (individual/family)
The 2026 HSA-compatible Bronze plan we would pick if we qualified for zero subsidies/CSRs (MAGI above 440% FPL, factoring in max HSA contributions)
- $19,140 in annual premium
- $7,500/$15,000 deductible (individual/family)
- $50 PCP
- $100 specialist
- $75 urgent care
- $25/$50 tier1/tier2 scripts
- 50% ER coinsurance
- $10,000/$20,000 MaxOOP (individual/family)
Previous ACA posts for those who want to review the comments, which are often quite informative:
- https://reddit.com/r/financialindependence/comments/17g8rev/2024_aca_prices_are_live_on_healthcaregov_for/
- https://reddit.com/r/financialindependence/comments/1gbzgfx/2025_aca_prices_are_live_on_healthcaregov_for/
- https://reddit.com/r/Fire/comments/17g8qdr/2024_aca_prices_are_live_on_healthcaregov_for/
- https://reddit.com/r/Fire/comments/1gbzgq4/2025_aca_prices_are_live_on_healthcaregov_for/
2026 ACA prices are live on Healthcare.gov for those who use the ACA or are curious about the state of FIRE health insurance.
byu/Zphr infinancialindependence
Posted by Zphr
3 Comments
>The 2026 Gold plan we would pick if our MAGI was just above 200% FPL (no meaningful CSRs):
> $2,952 in annual premium
Is this a typo? That seem impossibly low at 200% FPL
Saw an article with a couple with 120k combined pension getting like 15k in credits. They said they would have to go on less vacations if enhanced credits are gone
Average person isn’t going to feel bad for them
https://www.cnbc.com/2025/10/17/aca-enhanced-subsidy-lapse-government-shutdown.html
Nice info. For those trying to get just under the 400% FPL (or some other FPL limit) one nice thing about bronze plans is all of them are HSA compatible in 2026+. HSA contribution reduces MAGI.
So this effectively raises the FPL limit. The 400% FPL for two person household is $84,600 so you need a MAGI below this to get any subsidies. Even if the subsidies are relatively small targeting 400% FPL provides some assurances because premiums on silver plan are capped as a percentage of income (10% at 400% FPL). Bronze plans would be even less but you know premiums won’t be more than 10% of your AGI. This is how subsidies are computed. This is nice for planning purposes.
HSA contributions (which do not require earned income) are top of the line deductible meaning you can claim them even if not itemizing. The HSA limit is $8,750 for 2026.
This effectively allows an AGI excluding/before HSA contributions of $93,350. Now if you funded HSA contibutions by pulling funds from trad IRA well that wouldn’t help as $1 in deductions will result in $1 in income. However if you funded HSA contributions from idle cash, roth funds, or taxable brokerage account shares (ideally those with minimal gains) it can stretch your ability to get under the magic 400% FPL.