2023 Health Insurance Cost Calculator and Premium Subsidies

Obamacare Family of 3 Income Calculator

Under the old rules, this couple would have become ineligible for premium subsidies if they earned just $100 more. The American Rescue Plan eliminated this “subsidy cliff” for people like this couple through 2022.

People who experience changes in income over the course of a year should report these changes to the ACA marketplace so that their advance payments are accurate.

Income Calculator

This calculator estimates the cost of health insurance for families in 2023 based on expected household income. Families who are enrolled in an exchange plan through their employer or state marketplace and earn between 100 percent and 400 percent of the poverty level (FPL) can get advance premium tax credits to help pay for their coverage. The tool estimates the amount of APTC that a family will receive and compares it to their monthly premium cost for a silver plan.

When estimating your household income, include yourself, your spouse if married, and everyone you’ll claim as a tax dependent—even if they don’t need coverage. Also, estimate any changes you expect in your household size or income throughout the year.

Remember that your actual household income will be reported when you file your taxes a year from now, so only use the best estimate. Using the wrong information can result in you having to repay your APTC at tax time or paying too much for your premium.

Premium Subsidies

Generally, premium subsidies limit the amount you pay for your family’s exchange plan (or second-lowest cost silver plan) to a certain percentage of your household income. The amount you pay depends on a lot of factors, including the cost of your exchange plan, the number of people in your household, and whether any family members have other coverage like Medicare or employer-offered plans.

The COVID-19 pandemic ushered in legislation that expanded the ACA’s subsidy rules, and those changes have been extended through 2025 by the American Rescue Plan and Inflation Reduction Act. Normally, you can only get a premium subsidy if your projected household income is below 400% of the prior year’s poverty level.

Cost-Sharing Reductions

The ACA requires insurers to offer plans with reduced deductibles, copayments, and out-of-pocket maximums for people who qualify based on their income. These are known as cost-sharing reduction plans.

John has an expected annual income of 200% of the federal poverty level ($27,180 in 2022). So, he would be automatically enrolled in a silver plan with an 87 percent actuarial value (with lower deductibles and physician copayments than a standard silver plan).

However, if he opted to take a bronze plan instead, he might be eligible for a 63 percent actuarial value version of the same silver plan, which has higher deductibles and copayments, but lower out-of-pocket maximums. Since the premium tax credit only pays for his insurance, John might find it more affordable to buy the 63 percent actuarial value plan. Generally, individuals and families who receive premium tax credits to help pay their marketplace plans are also eligible for cost-sharing reductions. Those with the lowest incomes get the most assistance.

Tax Credits

The government offers premium tax credits that reduce the cost of your health insurance on the exchange. The amount you receive depends on your estimated household income. You can choose to have the government pay the credit directly to your insurer throughout the year to help with your premium, or you can claim it on your tax return.

The ACA’s premium tax credit is available to people with annual incomes between 100% and 400% of the poverty line who purchase coverage through an exchange. To qualify, you must be a citizen or lawfully present noncitizen and have no access to affordable employer-sponsored health coverage or Medicare.

If Tom and Renee have a third child (a qualifying event that triggers a special enrollment period), their after-subsidy premium will decrease because their income has decreased to a lower percentage of the poverty level (assuming they’re still paying the same amount in advance). This is because their household size has increased.

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