What crossing $63,840 costs, in all 23 states
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One dollar over $63,840 and the premium tax credit stops — not tapers, stops. For an employee that dollar is their employer’s decision. For an owner it is usually yours, which makes this a planning number rather than bad luck.
Enter a ZIP and your rough income and a licensed agent will tell you which side of the line you are on, and what it is worth doing about it.
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A single 40-year-old earning $63,839 pays no more than 10.22% of income for the benchmark plan — $543.70 a month. At $62,601 the credit is gone and the same plan costs full price. The right-hand column is the difference over a year.
| State | Benchmark @40 | Capped cost just under | Cost of crossing |
|---|---|---|---|
| Mississippi | $814/mo | $544/mo | $3,244 a year |
| Tennessee | $796/mo | $544/mo | $3,028 a year |
| Nebraska | $780/mo | $544/mo | $2,836 a year |
| Arkansas | $757/mo | $544/mo | $2,560 a year |
| Kansas | $748/mo | $544/mo | $2,452 a year |
| Florida | $738/mo | $544/mo | $2,332 a year |
| Texas | $737/mo | $544/mo | $2,320 a year |
| Georgia | $733/mo | $544/mo | $2,272 a year |
| Wisconsin | $720/mo | $544/mo | $2,116 a year |
| Utah | $716/mo | $544/mo | $2,068 a year |
| Alabama | $712/mo | $544/mo | $2,020 a year |
| Illinois | $707/mo | $544/mo | $1,960 a year |
| South Dakota | $704/mo | $544/mo | $1,924 a year |
| South Carolina | $702/mo | $544/mo | $1,900 a year |
| Oklahoma | $686/mo | $544/mo | $1,708 a year |
| North Carolina | $660/mo | $544/mo | $1,396 a year |
| Colorado | $615/mo | $544/mo | $856 a year |
| Ohio | $603/mo | $544/mo | $712 a year |
| Michigan | $595/mo | $544/mo | $616 a year |
| Nevada | $565/mo | $544/mo | $256 a year |
| Virginia | $549/mo | $544/mo | $64 a year |
| Indiana | $537/mo | $544/mo | Nothing |
| Maryland | $491/mo | $544/mo | Nothing |
Benchmark is the second-lowest-cost Silver plan at 40, enrollment-weighted, CMS PY2027. A 40-year-old is the reference age the whole site uses; see below for why age changes this more than anything else.
Indiana and Maryland. In those states the benchmark plan at 40 already costs less than $544 a month, so a single 40-year-old at $63,840 was never receiving a credit in the first place — there is nothing to lose by crossing. That is worth knowing before you spend an accountant’s afternoon engineering your income down to $62,500.
It also flips the other way. In Mississippi, Tennessee and Nebraska the same dollar is worth $3,244, $3,028 and $2,836 a year, and there the planning is worth doing properly.
Federal age rating lets an insurer charge a 64-year-old up to three times what it charges a 21-year-old, and the table above is a 40-year-old. An owner in their late fifties faces a benchmark far above the $544 cap in every one of these 23 states, which means the cliff is live everywhere — and the cost of crossing it is a multiple of the figures above. Household size moves the line too: $63,840 is the single-filer threshold, and it rises with each person in the household.
If you are over fifty and anywhere near the line, the arithmetic is worth doing with your real age, your real county and your real household. That is a phone call, not a table.
What you can actually move depends on your entity. An S-corp owner sets the split between W-2 salary and distributions. A sole proprietor or 1099 contractor is working with Schedule C net profit and retirement contributions. An LLC could be any of these depending on its election. And the self-employed health insurance deduction itself reduces the income the credit is measured against, so the deduction and the credit have to be worked out together rather than one after the other.
400% of the federal poverty level — $63,840 for a single-adult household in 2027, rising with household size. Below it you qualify for a premium tax credit; one dollar above it you qualify for nothing.
At age 40, yes. In Indiana and Maryland the benchmark plan already costs less than 10.22% of $63,840, so there is no credit at that income to lose. At older ages the benchmark is far higher and the cliff applies everywhere.
Often. Retirement contributions, the timing of income and expenses, and for an S-corp the salary and distribution split all move the income the credit is measured against. None of it is exotic, but it has to be decided before the year ends, not at tax time.
Benchmark premiums: the second-lowest-cost Silver plan for a 40-year-old, weighted by county enrollment, from the CMS PY2027 Landscape file, the same figures used across this site. Cliff: 400% of the 2026 HHS poverty guideline (91 FR 1797), $63,840 for a single-adult household. Applicable percentage: 10.22% for 2027 (Rev. Proc. 2026-26). Nothing here is tax advice — the arithmetic is public, the decision is yours and your CPA’s.