Big Changes Coming in 2026: Why Reviewing Your Health Insurance Early Could Save You Thousands

If you receive financial help through the Marketplace (ACA) to lower your monthly health insurance premiums, you’re probably familiar with the Advance Premium Tax Credit (APTC). This credit is based on your estimated income when you apply — but if your income ends up higher than expected, you may have to pay back some or all of that credit when you file your taxes.

How It Works Today (Through 2025)

Currently, there are repayment caps that limit how much you must pay back if your income is below 400% of the federal poverty level (FPL). For example, in 2025:

• A single filer earning between 100%–200% of FPL would have to repay at most $375, even if they received much more in excess subsidies.

• A married couple (filing jointly) in the same income range would have to repay at most $750.

• The cap increases as income rises, but it still provides a safety net for middle-income families.

What Changes in 2026

Starting in 2026, these repayment caps disappear. That means if your income ends up higher than what you reported on your application, you may have to repay the entire excess credit — no matter your income level.

For example:

• A family of four that estimated income at $55,000 but ended up at $65,000 could owe back every dollar of excess APTC received.

• Even households below 400% of FPL will no longer have repayment protection.