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What Is the Maximum Income to Qualify for the Affordable Care Act?

If you are looking for health insurance in Texas, you might be wondering what the maximum income is for you to qualify for Obamacare. Obamacare is a great option for individuals and families who are not covered under an employer-sponsored group health plan, but how much income can you have before you’re no longer eligible for it? We’ll answer that question and a few more in this article.

What Is Obamacare?

The Affordable Care Act (otherwise known as the ACA or Obamacare) is a healthcare bill that was passed in 2010. The bill aims to ensure affordable and accessible healthcare for everyone in the United States. ACA was created to help prevent insurance firms from using tactics to increase patient prices and restrict care for pre-existing conditions.
Obamacare also introduced subsidies and premium tax credits that would allow lower-income individuals and families who would otherwise not be able to purchase health insurance to obtain a plan. When it was first introduced, there was also a penalty imposed on any person who did not have health insurance. That portion of the law has not been in effect since 2019.

Who Is Eligible for Obamacare?

Any person who lives in the U.S., is a citizen, U.S. national, or lawfully present in the country can purchase an Obamacare plan. The only individuals in this category that are not eligible are those who are incarcerated or covered under the federal Medicare program.
While anyone is eligible to purchase health insurance under the ACA, only those with certain household incomes will qualify for financial assistance in the form of subsidies and premium tax credits. Subsidies will reduce a person’s monthly premiums and out-of-pocket costs for deductibles, coinsurance, and copayments. Household incomes that fall between 100% and 500% of the federal poverty level (FPL) qualify for some level of assistance. (The original threshold was 400% of the FPL, but that was extended to 500% as of 2021.)
For example, using the 2022 poverty levels, a family of four with an income between $27,750 (100% FPL) and $138,750 (500% FPL) would qualify for some sort of subsidy. (Amounts are higher in Hawaii and Alaska.)

What Is the Maximum Income for Obamacare?

As we mentioned, anyone can get an Obamacare plan, regardless of their income. But, if you’re wondering what the maximum income is to qualify for a subsidy, we’ve got that answer.
The maximum income amounts based on household size for 2022 are listed in the table below.

What Should I Do If I Can’t Afford Obamacare?

If you can’t afford Obamacare with or without a premium tax credit, you should find out if you qualify for Medicaid, a state-based insurance program. You can begin to determine this by filling out an Obamacare application. Some states even expanded their Medicaid programs under the ACA, so you may qualify based on your family size, household income, and other factors.
Individuals who don’t qualify for Medicaid may be able to find healthcare resources in community health centers and free clinics.
If you are in need of health insurance in Texas, we can help! Our licensed, independent agents will work with you to find a plan that meets your needs and your budget. We’ll help you determine if you qualify for an Obamacare subsidy or if you are eligible for other financial assistance. Call us today and request your complimentary consultation.