Key takeaways:
The Affordable Care Act (ACA) gives most people in the U.S. access to health insurance as long as they are U.S. citizens who live in the country or noncitizens who are lawfully present. You also cannot be incarcerated and can’t be covered by Medicare.
Under the ACA, consumers who have incomes from 100% to 400% of the federal poverty level may qualify for premium tax credits to reduce the monthly cost of their health plans.
In most states, the ACA has expanded the populations that are eligible for Medicaid.
Health insurance can be costly, especially if you don’t have a job that offers coverage as a benefit.
The Patient Protection and Affordable Care Act is a 2010 health-reform law also known as the ACA. The first plans to provide health coverage were effective in 2014.
The comprehensive ACA law has three main goals:
Make affordable health insurance available to more people.
Expand the Medicaid program.
Support medical care delivery that reduces costs.
The ACA offers many consumer protections, such as coverage for people who have preexisting conditions. The law also requires health plans to offer preventive care without out-of-pocket costs. And it allows adults under age 26 to stay on a parent’s health insurance plan. (In some states, certain adults can be 26 and older.)
Who is eligible for Obamacare?
Most people in the U.S. are eligible for ACA health insurance. But they must be U.S. citizens who live in the country or noncitizens who are lawfully present. Incarcerated people and those covered by Medicare are not eligible.
The ACA makes health insurance plans affordable for people regardless of income. An eligible individual at any income level can sign up for coverage on an ACA marketplace.
If you have a household income 100% to 400% of the federal poverty level (FPL), you may qualify for a premium tax credit. This is a subsidy based on income and other household information. It will reduce the monthly cost of health insurance for you and your family.
The FPL is updated every year. It is the same for the contiguous 48 states and Washington, D.C., but higher in Alaska and Hawaii.
2026 federal poverty level (FPL) snapshot
Household size | Income at 100% of FPL | Income at 400% of FPL |
|---|---|---|
1 | $15,960 | $63,840 |
2 | $21,640 | $86,560 |
3 | $27,320 | $109,280 |
4 | $33,000 | $132,000 |
5 | $38,680 | $154,720 |
Enhanced premium tax credits have significantly lowered premiums and expanded the population eligible for savings since 2021. In 2025, that meant savings in addition to standard premium tax credits for more than 90% of ACA enrollees — about 22 million people. These subsidies on the cost of plans were eliminated for the 2026 coverage year. As a result, many people now have higher premiums.
Who is not eligible for Obamacare?
You are not eligible for ACA health insurance if:
You do not live in the U.S.
You are incarcerated.
You aren’t a U.S. citizen, a U.S. national, or a lawfully present noncitizen in the U.S.
You are covered by Medicare.
If you aren’t a U.S. citizen or national but are lawfully present in the U.S., you may qualify for ACA insurance if your immigration status is one of the following:
Lawful permanent resident or green card holder
Refugee
Asylum seeker
Immigrant paroled into the U.S.
Nonimmigrant status, including those with worker visas and student visas
Deferred action status, excluding Deferred Action for Childhood Arrivals (DACA)
Cuban or Haitian entrant
Immigrant granted conditional entrance before 1980
Battered spouse, child, or parent
Victim of trafficking
Trafficking victim’s spouse, child, sibling, or parent
Special immigrant visa holders from Iraq or Afghanistan
Individual granted withholding of deportation or withholding or removal under immigration laws or the Convention Against Torture
Violence Against Women Act self-petitioners
Member of a federally recognized Indian tribe, or an American Indian born in Canada
Citizens of the Marshall Islands, Micronesia, and Palau living in a U.S. state or territory
Lawful temporary resident
Temporary protected status
Deferred enforced departure
Special immigrant juvenile classification
Family unity beneficiary
You may also be eligible if you’re an immigrant who has applied for certain statuses.
What is the income level to qualify for Obamacare?
Anyone who is eligible can buy health insurance from an ACA marketplace. But those with household incomes between 100% and 400% of FPL may qualify for premium tax credits.
What are the requirements to qualify for Obamacare?
You qualify for Obamacare if you:
Live in the U.S.
Are a U.S. citizen, a U.S. national, or a lawfully present noncitizen in the U.S. (Undocumented individuals can access marketplace plans in Washington state and Colorado)
Aren’t incarcerated
Aren’t covered by Medicare
Washington state lets undocumented people use its marketplace. Colorado has a separate site, called OmniSalud, for undocumented people to enroll in coverage.
How do I apply for Obamacare?
There are several ways to sign up for ACA insurance. First, determine if you need to use HealthCare.gov (if your state doesn’t have its own marketplace). You can sign up on your own, with an ACA navigator, or with an agent or a broker. After you determine whether you need help, you can:
Enroll online at HealthCare.gov.
Use the Find Local Help tool to locate in-person enrollment assistance in your area with a navigator, an agent, or a broker. All are trained to walk you through the marketplace process, and their services are free.
Apply through the website of a certified enrollment partner, such as a private health insurance company.
Enroll by phone by contacting the marketplace call center at 800-318-2596. This line is available 24-7, excluding holidays.
Complete and mail in an application.
How much does Obamacare cost monthly?
Your premium, or the amount you might pay monthly for an ACA insurance plan, will vary depending on where you live, your income, your household size, the plan you choose, and the amount of your premium tax credit.
Generally, ACA plans are organized into “metal” tiers, which determine how you and your plan split the cost of care. The tiers and their characteristics are listed in the chart below.
ACA metal tier | How cost sharing works | Estimated average |
|---|---|---|
Bronze | This plan has the lowest monthly premium but the highest costs when you need care. | Insurance pays 60%, and you pay 40%. |
Silver | This plan is known as the “benchmark” plan, with moderate monthly premiums and moderate costs when you need care. You must choose a silver plan to qualify for cost-sharing reductions, which will reduce your deductibles, copays, and coinsurance. | Insurance pays 70%, and you pay 30%. |
Silver with cost-sharing reductions | You will pay less in cost sharing. But the exact portion depends on how much in extra savings you’re qualified to receive. | Insurance pays 73% to 96%. |
Gold | This plan has high monthly premiums but low costs when you need care. | Insurance pays 80%, and you pay 20%. |
Platinum | This plan has the highest monthly premiums and the lowest costs when you need care. | Insurance pays 90%, and you pay 10%. |
*This is the estimated average cost sharing for a typical population. Your costs will vary.
Some states require health plans to be even more uniform to help consumers make comparisons. These are called standardized individual health plans. Each will have an identical deductible, copay, and coinsurance for specific services.
What you pay each month also depends on the plan you select. A KFF national analysis of marketplace plans for a 40-year-old person found that the average benchmark premium (a silver option without subsidies) is $625 in 2026, up from $497 in 2025. Prices range from $401 in New Hampshire to $1,299 in Vermont.
You may qualify for extra savings if you select a silver plan. These cost-sharing reductions will help you pay less out of pocket when you receive care. These savings apply to your deductible, copays, coinsurance, and out-of-pocket maximum.
What if I cannot afford Obamacare?
If you cannot afford ACA insurance, you may qualify for Medicaid, the state-based insurance program. Your ACA application can help you determine if you qualify for Medicaid.
Every state, Washington, D.C., and all five U.S. territories with permanent populations (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) have Medicaid programs. Medicaid qualification depends on your household income, family size, and other factors.
Under Obamacare, some states have expanded Medicaid to include a group of people with slightly higher incomes than the typically eligible population. If you do not qualify for Medicaid and cannot afford any ACA health plan, you have other free and low-cost health insurance options. You may have access to free and low-cost healthcare via community health centers.
Can you be denied Obamacare?
As long as you are eligible for ACA insurance and don’t have health insurance, you can’t be denied. That means that as long as you are living in the U.S. lawfully and aren’t incarcerated or covered by Medicare, you can enroll in an ACA plan. Depending on your income and other factors, you may not qualify for a premium tax credit or extra savings. Your application can be denied if you try to sign up outside the annual open enrollment period.
For 2027 coverage, the open enrollment period in late 2026 will become more uniform nationwide. Regardless of where you live and whether you use HealthCare.gov or a state marketplace, the open enrollment period must:
Begin no later than November 1
End by December 31
Last no longer than 9 weeks
If you miss open enrollment, you may qualify for a special enrollment period if you have a qualifying life event, such as:
Losing health coverage
Moving to a new state
Getting married
Having a baby
Adopting a child
What happens if my job circumstance changes while I’m on Obamacare?
If you have an ACA plan and you get a new job that offers health insurance, you will no longer be eligible for ACA subsidies. In that case, you may want to cancel your ACA plan and switch to your employer’s coverage.
If you have a new job that does not offer health insurance and your earnings exceed the income estimate on your Obamacare application, you may no longer qualify for the same amount in subsidies — or any at all. In that circumstance, you should update your application by reporting all income and household changes to HealthCare.gov. That way, you can determine if your premium tax credits or other savings will change. If you end up making less than your income estimate, you should also update your application because you may qualify for more savings.
If you have an employer-based health plan and lose your job, you qualify for a special enrollment period. That means you can apply for ACA health insurance outside open enrollment. You can also sign up to keep your job-based insurance through the Consolidated Omnibus Budget Reconciliation Act, known as COBRA, but you may have to pay the entire premium — including the part that had been picked up by your employer.
Does Obamacare differ from Medicaid?
Obamacare, or the ACA, is the 2010 health-reform law that makes affordable insurance more widely available to everyone, including those who do not qualify for Medicaid. Medicaid is a federal program administered by states that provides health insurance to individuals with low incomes.
The ACA also allows states to expand their Medicaid programs to cover people with slightly higher incomes. But states have the right to refuse Medicaid expansion. As of March 2026, the 10 states that have not expanded Medicaid are:
Alabama
Florida
Georgia
Kansas
Mississippi
South Carolina
Tennessee
Texas
Wisconsin
Wyoming
The bottom line
Millions of uninsured people in the U.S. can access health insurance through the Affordable Care Act (ACA). You are eligible to enroll in an ACA insurance plan as long as you are living in the U.S. lawfully and are not incarcerated or covered by Medicare. You may find out that you qualify for Medicaid during the ACA application process. If your job does not offer health insurance, you may be able to find an ACA health plan that meets your needs.
Why trust our experts?
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