One Dollar Over, and Your Health Insurance Help Stops

If you buy your own health insurance, the government may pay part of the bill for you. You buy that insurance on a government website called the marketplace.

Most people who get this help barely notice it. The money goes straight to the insurance company, so the bill that shows up is simply smaller.

There is a catch, and it is a big one. Earn one dollar too much and you lose the whole thing.

Where the line sits

The help has an income limit. Below it you get help, and above it you get none.

Here is the limit for 2027:

• If you live alone: $63,840
• If there are two of you: $86,560
• A family of four: $132,000

Why the limit is back

For four years, this limit was not there. A temporary rule protected people who earned above it, so the edge did not bite. That rule ended in 2025 and Congress has not brought it back, so the old limit is in force again.

The part that hurts at tax time

You sign up in November, for a year that has not happened yet. None of us knows exactly what we will earn, so you give the website your best guess.

The help gets paid all year based on that guess. Then your tax return shows what you really earned.

Guess low, finish above the line, and you have to pay back every dollar of help you were given. There is no limit on how much they can ask for.

Who this catches

The people it catches hardest are the ones whose pay is not the same every month:

• You work for yourself, and some months are better than others
• A bonus lands in December
• Company shares become yours, which counts as income that day

Any one of those can push you over a line you were sitting under in November.

Going over the line does not mean you did anything wrong. It is a rule with a sharp edge, and the whole trick is knowing where that edge is.

Two things you can do

Guess carefully. Start with what you earned last year, then think about what is different this year.

Then keep checking. You are allowed to change your income guess any time during the year, as often as you need to. Telling them in August is far easier than finding out in April.

If you think you will land anywhere near the limit, find your own number before you sign up. It depends on how many people are in your household, so a friend's number is probably not yours.

The dates

You can sign up between November 1 and January 15. If you want your plan to start on January 1, sign up by December 15.

Income is only half of the question. Who can get help at all is also changing for 2027, and I wrote about that in a separate article.

If you know someone who works for themselves, or who lost a job this year, send this before November.

If you would like help working out where you land, I am happy to go through it with you.