Reference Source

State health insurance marketplace assistance by state: who runs it, where subsidies start and stop, and what the state adds

One record per US state and the District of Columbia, stating who operates its health insurance marketplace, the income at which premium tax credit eligibility begins there, whether a coverage gap exists below it, and what the state itself adds on top of the federal credit. When the ACA's enhanced premium tax credits lapsed on 31 December 2025 a group of states stood up or expanded their own premium assistance to absorb part of the loss, and they did so on completely different terms: New Mexico backfills the full loss below 400% of the poverty line and caps benchmark premiums at 8.5% of income above it; New Jersey's assistance runs to 600% of the poverty line; Maryland covers the whole loss below 200% and part of it to 400%; California stops at 165%; Colorado pays a flat monthly amount; Washington pays per member per month. In ten states that never adopted the Medicaid expansion, a household below the poverty line still qualifies for nothing at all. Whether the federal cutoff at 400% of the poverty line is a cliff or a slope therefore depends entirely on the state, and no page states the answer for all fifty-one. Answers 'does my state have its own health insurance subsidy', 'what is the income limit for marketplace insurance in [state]', 'am I in the coverage gap', 'does [state] have a health insurance mandate', and 'when does open enrollment end in [state]'.

Records51
Sources54
Verified
Review by
LicenceFacts extracted from state marketplace, state insurance department and state Medicaid agency pages. Programme names, income thresholds, payment amounts, mandate penalties and enrollment dates are statutory or administrative facts and not copyrightable (Feist, 1991). Each record cites the state page it came from and quotes a short passage linking back. Compilations by third parties (KFF, healthinsurance.org) are used only to locate the state's own page and are never the cited source for a value.

2 records where two or more sources state different values. Both sides are reproduced on the record page, each with its own source and quote.

The data

StateMarketplace typeMarketplace nameMarketplace websiteMedicaid expansion adoptedWhere premium tax credit eligibility startsCoverage gap below the poverty lineState premium assistance programmeState assistance above 400% of the poverty lineState cost-sharing programmeBasic Health ProgramState individual mandateOpen enrollment opensOpen enrollment closesCoverage year these dates are forIncome range for state assistanceMandate penaltyWhat the state programme pays
Alabamafederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
AlaskaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
ArizonaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026December 15, 20262027
Arkansasstate-based marketplace on federal platform (SBM-FP)Arkansas Health Insurance Marketplacehttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1January 152026
CaliforniaState-based marketplaceCovered Californiahttps://www.coveredca.com/yes138% of the federal poverty linenoCalifornia Premium Subsidynononenoneyesup to 150% of the federal poverty levelthe greater of 2.5% of household income or $900 per adult and $450 per child, up to a family maximum of $2,700
ColoradoState-based marketplaceConnect for Health Coloradohttps://connectforhealthco.com/yes138% of the federal poverty linenoColorado Premium Assistancenononenoneno2025-11-012026-01-152026up to 400% of the federal poverty level$80 for the first household member and $29 for each subsequent household member that pays a premium
ConnecticutState-based marketplaceAccess Health CThttps://www.accesshealthct.com/yes138% of the federal poverty linenoCovered CT ProgramnoCovered CT Programnonenoup to 175% of the federal poverty levelThe State of Connecticut will pay a customer's portion of their monthly payment (premium) directly to the customer's insurance company and it will also pay for the cost-sharing amounts (deductibles, co-pays, and co-insurance)
DelawareFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
District of ColumbiaState-based marketplaceDC Health Linkhttps://www.dchealthlink.com/yes200% of the federal poverty level (Medicaid covers up to 138% FPL; Healthy DC Plan BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)nononenononeHealthy DC Planyes2026-11-012026-12-312027the same as the federal shared responsibility payment as it stood on December 15, 2017: the greater of 2.5% of household income or $695 per uninsured adult and $347.50 per uninsured child, up to a family maximum of the District average bronze-plan premium (the District shared responsibility payment is reduced by any federal shared responsibility payment owed)
Floridafederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
Georgiastate-based marketplace (SBM)Georgia Accesshttps://georgiaaccess.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
HawaiiFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
IdahoState-based marketplaceYour Health Idahohttps://www.yourhealthidaho.org/yes138% of the federal poverty linenononenononenoneno
Illinoisstate-based marketplace (SBM)Get Covered Illinoishttps://getcovered.illinois.gov/yes138% of the federal poverty linenononenononenonenoNovember 1January 152026
IndianaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
IowaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
Kansasfederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
Kentuckystate-based marketplace (SBM)kynecthttps://kynect.ky.gov/yes138% of the federal poverty linenononenononenonenoNovember 1January 152026
LouisianaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
Mainestate-based marketplace (SBM)CoverME.govhttps://www.coverme.gov/yes138% of the federal poverty linenononenononenonenoNovember 1January 152026
MarylandState-based marketplaceMaryland Health Connectionhttps://www.marylandhealthconnection.gov/yes138% of the federal poverty linenoMaryland Premium Assistancenononenonenoup to 400% federal poverty levelMaryland residents of any age with incomes up to 400% federal poverty level may be able to receive help paying for their monthly health insurance costs thanks to a new state program
MassachusettsState-based marketplaceMassachusetts Health Connectorhttps://www.mahealthconnector.org/yes138% of the federal poverty linenoConnectorCarenoConnectorCarenoneyes100% to 400% of the federal poverty levelConnectorCare plans have $0 or low monthly premiums, low out-of-pocket costs, and no deductibles
MichiganFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
MinnesotaState-based marketplaceMNsurehttps://www.mnsure.org/yes200% of the federal poverty level (MinnesotaCare BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)nononenononeMinnesotaCareno2026-11-012026-12-312027
Mississippifederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
MissouriFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
MontanaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026December 15, 20262027
NebraskaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026December 15, 20262027
NevadaState-based marketplaceNevada Health Linkhttps://www.nevadahealthlink.com/yes138% of the federal poverty linenononenononenoneno
New HampshireFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
New JerseyState-based marketplaceGetCoveredNJhttps://www.nj.gov/getcoverednj/yes138% of the federal poverty linenoNew Jersey Health Plan Savingsyesnonenoneyesup to 600% of the federal poverty levelTax households with annual incomes up to 600% of the federal poverty level will receive NJHPS. An individual with an income of up to $93,900 and a family of four who makes up to $192,900 can receive state subsidies to lower the costs of health coverage.
New MexicoState-based marketplaceBeWell, New Mexico's Health Insurance Marketplacehttps://bewellnm.com/yes138% of the federal poverty linenoNew Mexico Premium AssistanceyesState Out-of-Pocket Assistance (SOPA)nonenoall income levels, including above 400% of the federal poverty levelbackfills the full loss of the enhanced federal credit, meaning no disruptions in coverage or cliffs for financial assistance
New Yorksources differState-based marketplaceNY State of Healthhttps://nystateofhealth.ny.gov/yes138% of the federal poverty linenononenoSilver Supreme and Silver Enhanced cost-sharing reduction plansEssential Planno
North CarolinaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026December 15, 20262027
North DakotaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
OhioFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026December 15, 20262027
OklahomaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
OregonState-based marketplaceOregon's Health Insurance Marketplacehttps://healthcare.oregon.gov/Pages/index.aspxyes200% of the federal poverty level (OHP Bridge BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)nononenononeOHP Bridgeno2026-11-012026-12-312027
PennsylvaniaState-based marketplacePenniehttps://www.pennie.com/yes138% of the federal poverty linenononenononenoneno
Rhode IslandState-based marketplaceHealthSource RIhttps://www.healthsourceri.com/yes138% of the federal poverty linenononenononenoneyes
South Carolinafederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
South DakotaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
Tennesseefederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
Texasfederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026
UtahFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenoneno2026-11-012027-01-152027
VermontState-based marketplaceVermont Health Connecthttps://vermonthealthconnect.gov/yes138% of the federal poverty linenoVermont Premium AssistancenoEnhanced Silver plansnoneyesup to 300% of the federal poverty levelVermont requires reporting but imposes no financial penaltyVPA lowers your monthly health insurance bill by 1.5% of your household income
VirginiaState-based marketplaceVirginia's Insurance Marketplacehttps://www.marketplace.virginia.gov/yes138% of the federal poverty linenoVirginia Premium Savingsnononenoneno2026-11-012027-01-292027138% to 250% of the federal poverty levelstate subsidies funded through the Virginia Health Insurance Affordability Fund, created by the Virginia General Assembly in a 2026 special session; amount per enrollee not stated on this page
Washingtonsources differState-based marketplaceWashington Healthplanfinderhttps://www.wahealthplanfinder.org/yes138% of the federal poverty linenoCascade Care Savingsnononenonenoup to 250% of the federal poverty levelCustomers with federal subsidies: $55 per member, per month (PMPM). Customers without federal subsidies: $250 PMPM
West VirginiaFederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/yes138% of the federal poverty linenononenononenonenoNovember 1, 2026January 15, 20272027
Wisconsinfederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty linenononenononenonenoNovember 1January 152026
Wyomingfederally-facilitated marketplaceHealthCare.govhttps://www.healthcare.gov/no100% of the federal poverty lineyesnonenononenonenoNovember 1January 152026

Where this came from

Every record above links the page it was taken from and quotes the sentence that states it. These are the 54 sources this dataset was assembled from.

Machine-readable

51 records. last verified against source . due for re-check by .

Licence. Facts extracted from state marketplace, state insurance department and state Medicaid agency pages. Programme names, income thresholds, payment amounts, mandate penalties and enrollment dates are statutory or administrative facts and not copyrightable (Feist, 1991). Each record cites the state page it came from and quotes a short passage linking back. Compilations by third parties (KFF, healthinsurance.org) are used only to locate the state's own page and are never the cited source for a value.