Every number, and where it comes from
This page is generated from the same two files the calculator loads at run time, so it stays in step with what the calculator actually does. Generated 2026-10-25 for the 2026 coverage year.
1. The law this calculator models
IRC section 36B as amended by P.L. 119-21 (One Big Beautiful Bill Act, enacted 4 July 2025) and indexed for 2026 by Rev. Proc. 2025-25. This is the law in effect for the 2026 coverage year, and it is the only law this calculator models.
Enhanced subsidies: expired as of 2026-10-25. Both are gone for the 2026 coverage year. The applicable-percentage table tops out at 400% of the poverty line, so there is no premium tax credit above 400% FPL, and the required contribution rises with income up to 9.96% of household income.
The American Rescue Plan Act of 2021 (P.L. 117-2) section 9661 enhancements to IRC section 36B, extended by the Inflation Reduction Act of 2022: (1) the 8.5%-of-household-income cap on the required contribution, and (2) premium tax credit eligibility above 400% of the federal poverty line.
2. The applicable percentage table for 2026
Read from Rev. Proc. 2025-25, 2026-2 I.R.B. (section 3.01, Applicable Percentage Table for 2026). Inside a band the percentage moves in a straight line from the initial to the final value, per Within a band the percentage moves in a straight line from the band's initial percentage at its lower bound to its final percentage at its upper bound, per 26 CFR 1.
| Household income as a share of the poverty line | Initial | Final |
|---|---|---|
| less than 133% | 2.10% | 2.10% |
| 133% to 150% | 3.14% | 4.19% |
| 150% to 200% | 4.19% | 6.60% |
| 200% to 250% | 6.60% | 8.44% |
| 250% to 300% | 8.44% | 9.96% |
| 300% to and including 400% | 9.96% | 9.96% |
No row exists above 400% of the poverty line: the table ends there, which is what makes 400% a cliff for 2026.
3. The poverty guidelines
45 CFR 155.300(a) defines the federal poverty level for a coverage year as the most recently published HHS guidelines as of the FIRST DAY of that year's annual open enrollment period. Open enrollment for the 2026 coverage year began 1 November 2025, and the 2026 guidelines were not published until 15 January 2026. The 2025 guidelines are therefore the ones that govern 2026 coverage, and they are what the Marketplace itself uses. Both tables are recorded below, and the 2026 table is what 2027 coverage will use.
| People | 2025 (used) | 2026 (next) |
|---|---|---|
| 1 | $15,650 | $15,960 |
| 2 | $21,150 | $21,640 |
| 3 | $26,650 | $27,320 |
| 4 | $32,150 | $33,000 |
| 5 | $37,650 | $38,680 |
| 6 | $43,150 | $44,360 |
| 7 | $48,650 | $50,040 |
| 8 | $54,150 | $55,720 |
Above 8 people, add $5,500 for each additional person in the 2025 table.
4. The credit
What follows is a description of what the statute provides. It is not advice about anyone's tax position, and a tax professional is the right person for a tax question.
Annual credit = benchmark silver premium for the household - (household income x applicable percentage), floored at zero, and never more than the premium of the plan actually enrolled. Monthly figures are the annual figure divided by 12.
The second-lowest-cost silver plan offered through the Exchange in the applicant's rating area, priced for the whole household.
Income floor. Household income at or above 100% of the poverty line for the household size. 26 CFR 1.36B-2(b)(2) lets the Exchange grant savings to someone lawfully present in the United States whose household income is below 100% of the poverty line, where the Exchange finds Florida Medicaid is not the route for them. In a state that did not expand Medicaid this is what separates the coverage gap from a subsidised plan, and it turns on facts this calculator does not ask about.
Income ceiling. No premium tax credit above 400% of the poverty line for 2026 (see enhanced_subsidies).
What you type versus what the law uses. A visitor typing a salary figure is giving a close proxy, not a MAGI figure. The calculator says so on the results screen rather than implying precision it does not have.
5. Cost-sharing reductions
Enrolled in a SILVER plan through the Exchange and otherwise eligible for a premium tax credit.
| Income | Actuarial value | Level |
|---|---|---|
| 100% – 150% | 94% | 94% actuarial value |
| 150% – 200% | 87% | 87% actuarial value |
| 200% – 250% | 73% | 73% actuarial value |
The published CSR variants in the CMS plan-attributes PUF (94%, 87%, 73%, plus the zero and limited cost-sharing variants) are the carrier-level confirmation that these three tiers are what is sold in 2026.
6. Medicaid in Florida
Florida has not adopted the ACA Medicaid expansion. Its income-based adult coverage is limited to parents and caretaker relatives of children on the return, and to people who qualify through age, blindness or disability. An adult 19-64 with no child on the return sits outside every income-based adult group, whatever the income, which is why the calculator points to both Florida Medicaid and the Marketplace rather than picking one.
| Group | Income limit | Program |
|---|---|---|
| Children under 19 | 210% | Florida Medicaid (to 133% FPL) then Florida KidCare / CHIP (to 210% FPL) |
| Pregnant applicants | 196% | Florida Medicaid for pregnant women |
| Parents and caretaker relatives | 31% | Florida family-related Medicaidapproximate — confirm with Florida Medicaid |
| Aged, blind or disabled (SSI-related) | 74% | Florida Medicaid, SSI-related |
The calculator never asks about disability, pregnancy, immigration status, medical conditions or household composition beyond ages and count. Each of those changes which Medicaid group applies, so the Medicaid flag is presented as a prompt to check with Florida Medicaid, never as a decision.
7. The premiums
Every premium is read from the CMS Marketplace public use files for the 2026 benefit year: 4,044 individual medical plans, of which 1,453 qualify as a benchmark (standard silver, offered on the Exchange). The benchmark is the second-lowest-cost silver plan for the household, computed by summing each qualifying plan's published per-age rate over the household's members and taking the second cheapest.
Coverage. 29 states file individual-market rates in the federal PUF. Florida is modelled at county level (67 counties, 1,013 ZIP codes). A ZIP outside Florida gets its state figure; a state absent from the PUF gets the national figure. Both are labelled in the UI. 67 Florida counties and 1,013 ZIP codes are priced from county filings; 29 states publish rates in this file.
The county map. The public files do not publish a county-to-rating-area map, so it is solved from the per-plan county coverage and the per-plan rating areas. In Florida those two sets are always the same size, which is what makes the map a bijection over 67 counties and 67 rating areas (confirmed). 8 counties are not uniquely determined; for those the published benchmark is the band spanning every possible answer rather than one arbitrary pick.
Ages. Florida plans publish rates for ages 15 to 63. A younger member is priced at the published age-15 rate and an older one at age 63, and the result screen names every age that was carried over.
8. How a date of birth becomes an age
Age is the biggest factor in a plan price, so the calculator asks for a date of birth for every person on the application rather than a typed age. Each one is turned into an age as of 1 January 2026, the first day of the coverage year being modelled, and that age is what the premium tables are read with. The person applying must be 18 or older because they are the one giving consent; a child is priced on the same application as their parent or guardian. A member of 65 or over is priced at the top of the published age curve as a guide and flagged for Medicare. The dates of birth themselves are stored encrypted, and logs carry only the age and birth year.
8. What is never asked
- Tobacco use — a rating factor of up to 1.5x. Not asked, so every figure is the non-tobacco premium, and the result says so.
- Health conditions — never asked and never stored.
- Immigration status — never asked, though it can decide whether the below-100%-of-poverty-line exception applies.
- Disability or pregnancy — never asked, though each changes which Medicaid group applies. That is why the Medicaid flag is a prompt to check, never a decision.
- Social Security number, card details, passwords — no field for them exists, and the server drops those keys from any request that carries them.
9. Sources
- Applicable percentage table (2026) — Internal Revenue Service, Rev. Proc. 2025-25 (PDF) · read 2026-10-25
- Poverty guidelines that govern 2026 coverage — Annual Update of the HHS Poverty Guidelines, 90 FR (17 January 2025) · read 2026-10-25
- Which poverty guideline year applies — 45 CFR 155.300(a), definition of Federal poverty level or FPL · read 2026-10-25
- 2026 poverty guidelines (governs 2027 coverage) — Annual Update of the HHS Poverty Guidelines, 91 FR 1797 (15 January 2026) · read 2026-10-25
- Enhanced subsidy status — HHS Notice of Benefit and Payment Parameters for 2027 (20 May 2026) · read 2026-10-25
- Marketplace premiums (PY2026 public use files) — CMS Marketplace Public Use Files · read 2026-10-25
- ZIP to county and county names — Census 2020 ZCTA to county relationship file · read 2026-10-25
10. Rebuilding
The dataset is reproducible: bash scripts/fetch_puf.sh then
python3 scripts/build_premiums.py rebuilds the premiums and writes a
report with a SHA-256 of every input file, so a restated source is visible rather than
silent. python3 scripts/build_methodology.py regenerates this page.