Health Insurance Affordability Calculator
See what your health premium costs as a share of your income — and whether you have crossed the ACA affordability line where marketplace subsidies may kick in.
Written by Dorothy Ibrahim, 10+ years in banking & finance
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How we calculate this
Without an employer covering most of the bill, freelancers pay the full sticker price for health coverage — and it is easy to end up spending a share of income that would qualify for help you did not know existed. This tool shows what your premium costs as a percentage of your income and flags whether you have crossed the ACA affordability line where marketplace premium subsidies become plausible. It is a directional signpost only, not a subsidy calculation.
The formulas
- Premium as a share of income
- monthly premium ÷ net monthly income
- Annual premium cost
- monthly premium × 12
- Unaffordable flag
- premium share of income > 9.96%Only evaluated when income is greater than $0; the 9.96% line is the 2026 ACA affordability threshold.
Worked example
- With the defaults — a $550 monthly premium and $6,000 net monthly income — the premium share of income is $550 ÷ $6,000 = 9.17%.
- The annual premium cost is $550 × 12 = $6,600.
- 9.17% is below the 9.96% ACA affordability threshold, so this premium is flagged as affordable and a marketplace subsidy is less likely (though still worth checking at open enrollment).
Rates, benchmarks & sources
- The 9.96% ACA affordability benchmark (up from 9.02% for 2025) used here as the marketplace-eligibility signpost. — IRS Rev. Proc. 2025-25 (§36B required-contribution percentage for 2026)
- Where the actual premium tax credit (subsidy) amount is determined. — HealthCare.gov — Marketplace and premium tax credits
- Background on how premium tax credit eligibility and amounts are computed. — IRS Publication 974, Premium Tax Credit
Figures current as of 2026-07-02. See our methodology & editorial standards for how constants are versioned and verified.
What this tool doesn’t model
- Does not calculate a premium tax credit (subsidy) amount — that depends on household size, exact annual income, and the benchmark plan in your area, and is determined on the marketplace itself.
- Uses a single monthly income and premium figure as a directional estimate; the official ACA benchmark is based on annual household income, which can differ from a representative monthly figure.
- State-based marketplaces and Medicaid expansion status vary and are not modeled here.
Frequently asked questions
What counts as unaffordable health insurance?
The ACA uses an affordability benchmark — a percentage of household income — to decide who qualifies for help. When your premium for benchmark coverage exceeds that percentage, you may be eligible for premium tax credits on the marketplace. This tool compares your premium to that line as a first signal; it does not compute your exact subsidy.
Does this calculate my subsidy?
No. Premium tax credits depend on household size, exact income, your local benchmark plan, and more — that math lives on the marketplace itself. This tool tells you whether you are on the side of the line where a subsidy is plausible, so you know whether it is worth applying.
Can I deduct my premiums instead?
Often yes. Self-employed people can usually deduct health insurance premiums against income tax (the self-employed health insurance deduction), up to their net profit. You cannot double up: premiums covered by a marketplace subsidy are not also deductible. See the SE Health Insurance Deduction calculator for that math.
What income figure should I use?
Use your net monthly income — roughly take-home pay or net profit. The official affordability benchmark is based on household income for the year; entering a representative monthly figure gives you a quick, directional read rather than an exact eligibility determination.
Does this tool tell me if I qualify for Medicaid instead?
No — Medicaid eligibility depends on your state (many states have expanded Medicaid, some have not) and your household income relative to the federal poverty level, which is separate math from the ACA marketplace affordability threshold used here. Check your state marketplace or Medicaid agency directly.