Earn just over 400% of the poverty line and the tax credit stops. What the benchmark plan then costs in 23 states at age 40, at 60 and for a family of four.
Prefer to talk? Call (713) 575-9904
Licensed Independent Agent · NPN #22052447 · 23 States
The premium tax credit stops at 400% of the federal poverty line. For 2026 coverage that is $62,600 for one person, $84,600 for a couple and $128,600 for a family of four. Just under the line, the benchmark Silver plan costs you at most 9.96% of income. One dollar over, the credit is gone and you pay the full price.
The table shows that full price in each of the 23 states covered here, and how much of your income it takes right at the line. It is ranked by the 60-year-old column, because that is where the line hurts most: the benchmark plan takes from 16.9% of income in Maryland to 31.5% in Arkansas, which is $4,315 to $13,489 a year more than it would cost one dollar lower. For a family of four it takes 12.4% (Maryland) to 23.1% (Arkansas).
For a single 40-year-old the line barely bites in 5 states: in Indiana, Maryland, Nevada, Ohio and Virginia the full benchmark price is already under 9.96% of $62,600, so crossing it costs nothing extra on that plan.
| Rank | State | 40-year-old | Share of $62,600 | 60-year-old | Share of $62,600 | Extra a year | Couple, both 40 | Share of $84,600 | Family of four | Share of $128,600 | Extra a year |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Arkansas | $774/mo | 14.8% | $1,644/mo | 31.5% | $13,489 | $1,548/mo | 22.0% | $2,475/mo | 23.1% | $16,887 |
| 2 | Tennessee | $711/mo | 13.6% | $1,510/mo | 28.9% | $11,884 | $1,422/mo | 20.2% | $2,273/mo | 21.2% | $14,470 |
| 3 | Nebraska | $710/mo | 13.6% | $1,508/mo | 28.9% | $11,858 | $1,420/mo | 20.1% | $2,270/mo | 21.2% | $14,431 |
| 4 | Florida | $683/mo | 13.1% | $1,450/mo | 27.8% | $11,170 | $1,366/mo | 19.4% | $2,184/mo | 20.4% | $13,396 |
| 5 | Kansas | $670/mo | 12.8% | $1,423/mo | 27.3% | $10,839 | $1,340/mo | 19.0% | $2,142/mo | 20.0% | $12,897 |
| 6 | Mississippi | $662/mo | 12.7% | $1,406/mo | 26.9% | $10,635 | $1,324/mo | 18.8% | $1,982/mo | 18.5% | $10,974 |
| 7 | Texas | $661/mo | 12.7% | $1,404/mo | 26.9% | $10,610 | $1,322/mo | 18.8% | $2,113/mo | 19.7% | $12,552 |
| 8 | South Dakota | $655/mo | 12.6% | $1,391/mo | 26.7% | $10,457 | $1,310/mo | 18.6% | $2,094/mo | 19.5% | $12,321 |
| 9 | Illinois | $646/mo | 12.4% | $1,372/mo | 26.3% | $10,227 | $1,292/mo | 18.3% | $2,065/mo | 19.3% | $11,976 |
| 10 | Alabama | $645/mo | 12.4% | $1,370/mo | 26.3% | $10,202 | $1,290/mo | 18.3% | $1,931/mo | 18.0% | $10,363 |
| 11 | North Carolina | $638/mo | 12.2% | $1,355/mo | 26.0% | $10,024 | $1,276/mo | 18.1% | $2,040/mo | 19.0% | $11,669 |
| 12 | Georgia | $615/mo | 11.8% | $1,306/mo | 25.0% | $9,437 | $1,230/mo | 17.4% | $1,966/mo | 18.3% | $10,787 |
| 13 | Utah | $640/mo | 12.3% | $1,298/mo | 24.9% | $9,343 | $1,280/mo | 18.2% | $1,966/mo | 18.3% | $10,787 |
| 14 | Wisconsin | $611/mo | 11.7% | $1,298/mo | 24.9% | $9,335 | $1,222/mo | 17.3% | $1,953/mo | 18.2% | $10,633 |
| 15 | Oklahoma | $604/mo | 11.6% | $1,283/mo | 24.6% | $9,157 | $1,208/mo | 17.1% | $1,931/mo | 18.0% | $10,365 |
| 16 | South Carolina | $564/mo | 10.8% | $1,198/mo | 23.0% | $8,138 | $1,128/mo | 16.0% | $1,803/mo | 16.8% | $8,830 |
| 17 | Colorado | $557/mo | 10.7% | $1,183/mo | 22.7% | $7,959 | $1,114/mo | 15.8% | $1,781/mo | 16.6% | $8,561 |
| 18 | Michigan | $523/mo | 10.0% | $1,111/mo | 21.3% | $7,093 | $1,046/mo | 14.8% | $1,672/mo | 15.6% | $7,257 |
| 19 | Ohio | $513/mo | 9.8% | $1,089/mo | 20.9% | $6,838 | $1,026/mo | 14.6% | $1,640/mo | 15.3% | $6,873 |
| 20 | Nevada | $497/mo | 9.5% | $1,055/mo | 20.2% | $6,430 | $994/mo | 14.1% | $1,589/mo | 14.8% | $6,259 |
| 21 | Indiana | $474/mo | 9.1% | $1,007/mo | 19.3% | $5,844 | $948/mo | 13.4% | $1,515/mo | 14.1% | $5,377 |
| 22 | Virginia | $455/mo | 8.7% | $966/mo | 18.5% | $5,360 | $910/mo | 12.9% | $1,455/mo | 13.6% | $4,648 |
| 23 | Maryland | $414/mo | 7.9% | $879/mo | 16.9% | $4,315 | $828/mo | 11.7% | $1,324/mo | 12.4% | $3,075 |
Full price = KFF’s 2026 average benchmark premium (second-lowest-cost Silver, age 40, weighted by plan selections) for each state. 60-year-old and children use the federal age curve; Alabama, Mississippi and Utah set their own, so their ratios come from the CMS Plan Year 2026 plan records. Couple = two 40-year-olds; family of four = two 40-year-olds and two children under 15. Share = a year of full price divided by the income at the line. Extra a year = full price minus 9.96% of that income, the most the same plan would cost with the credit. Your county and plan will differ. Not a quote or an offer of coverage. Checked October 25, 2026.
The credit is based on the income you expect for the year, not what you made last year. For the self-employed that is net profit, and contributions to a SEP-IRA, a solo 401(k) or a health savings account lower the income the credit is measured against. In a good year those can be the difference between paying 9.96% of income and paying full price. Work it out before you pick a plan, because an estimate that turns out too low gets paid back at tax time.
At full price, the marketplace is not the only option worth pricing. If you are healthy, a privately underwritten plan can cost less than the full-price benchmark; it covers less, and its price depends on your health answers. A licensed agent can show you both side by side and say which one fits your situation.
For 2027 coverage the line moves to $63,840 for one person, $86,560 for a couple and $132,000 for a family of four, and the cap under it to 10.22% of income. This page switches to 2027 prices when they are published in late October.
More: health insurance comparison chart by state · 2027 rate increases by state · the age curve by state · for business owners
A state average can’t tell you that. Enter your ZIP and a licensed agent will send you the real 2027 prices for your county as soon as they’re posted, and what you’d pay after any credit you qualify for. It costs nothing, and you deal with a licensed agent, not a call center.
What You Pay Above the Subsidy Cliff, State by State · Health Insurance Comparison Chart by State · Health Insurance Rating Areas, State by State · Health Insurance Premiums by Age, State by State · Insurers Leaving the ACA Marketplace in 2027 · Cheapest States for Health Insurance 2026 — All 51 Jurisdictions · Cheapest States for Health Insurance (2026) · 7 States With No PPO Plans · Where One Insurer Controls the Market · The Age Curve, State by State · Where Your County Matters Most · Carrier Competition by State
Premiums are set county by county, so a state average tells you very little. Enter your ZIP and a licensed agent will send you the plans filed where you live.
★★★★★
“I run my own business and my time is valuable. Daniel handled everything — compared the private options, explained what I was actually getting, and had me covered fast. Way better experience than trying to navigate it myself.”