ACA Marketplace Plans- Eligibility

To enroll in a Marketplace plan, you must:

• Be a resident of a U.S. state or D.C. (not U.S. territories) 

• Be a U.S. citizen or “lawfully present” non‑citizen (e.g., refugees, asylees, visa holders) 

• Not be incarcerated

 

DACA Status

• As of Nov 1, 2024, DACA recipients in states not party to a federal injunction are considered lawfully present and can enroll and qualify for subsidies.

• In 19 states under court injunction, DACA residents remain ineligible for Marketplace coverage 

 

Financial Assistance: Subsidy Eligibility in 2025

Income Requirements

• To qualify for advance premium tax credits (APTC), your income must be at least 100% of the federal poverty level (FPL) and typically under 400%, though expanded eligibility applies through 2025.

• For 2025, FPL is approximately $15,060 for a single adult and $31,200 for a household of four.

 

Expanded Subsidies

• Enhanced subsidies enacted by the American Rescue Plan and Inflation Reduction Act remain in effect through the 2025 plan year.

• These enhancements:

  • Cap premium costs at 8.5% of income even above 400% FPL

  • Zero monthly cost for those at or below 150% FPL (about $22,590/year for an individual in 2025)

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Important: Unless renewed by Congress, these enhanced benefits expire 12/31/2025 — meaning substantial premium hikes and loss of subsidy eligibility beginning in 2026