Key Takeaways
- Your PROJECTED income determines subsidies, not last year's
- Marketplace is often much cheaper than COBRA
- Layoff gives you a 60-day special enrollment window
The ACA Marketplace
"I don't qualify for Obamacare—I made too much" — That was last year. This year is different.
Why Marketplace Often Wins
The key insight: subsidies are based on your projected income for THIS year, not last year's taxes.
If you earned $150,000 last year but expect $50,000 this year (severance + unemployment + part of a new salary), your subsidies are based on $50,000.
How Subsidies Work (2025)
| 2025 Federal Poverty Level (Single) | Subsidy Level |
|---|---|
| Up to 150% FPL (~$22,590) | Maximum subsidies |
| 150-200% FPL (~$30,120) | Large subsidies |
| 200-300% FPL (~$45,180) | Moderate subsidies |
| 300-400% FPL (~$60,240) | Small subsidies |
| 400%+ FPL | Subsidies still available (enhanced through 2025) |
⚠️ IMPORTANT: Enhanced ACA subsidies expire December 31, 2025. If Congress doesn't extend them, subsidies above 400% FPL will disappear and costs will increase significantly in 2026.
Example: A family of 4 earning $60,000 projected income might pay $200-400/month for a Silver plan vs. $2,249/month average for family COBRA.
The Special Enrollment Period
Losing job-based coverage is a "qualifying life event" that gives you:
- 60 days to enroll in Marketplace coverage
- Coverage starts the first of the month after enrollment
- You don't have to wait for open enrollment
Plan Types
| Metal Level | Premium | Out-of-Pocket Costs | Best For |
|---|---|---|---|
| Bronze | Lowest | Highest | Healthy, minimal care |
| Silver | Moderate | Moderate | Most people |
| Gold | Higher | Lower | Regular care needs |
| Platinum | Highest | Lowest | High medical needs |
Silver Sweet Spot: If income is 100-250% FPL, Silver plans offer "cost-sharing reductions" that lower deductibles and copays—not just premiums.
How to Estimate Your Projected Income
Add up what you expect to receive this calendar year:
| Income Source | Include? |
|---|---|
| Wages earned so far | Yes |
| Severance pay | Yes (if paid this year) |
| Unemployment benefits | Yes |
| Investment income | Yes |
| Expected new job income | Yes (estimate) |
| Retirement withdrawals | Yes |
Be reasonably accurate. If you underestimate and earn more, you'll owe subsidy repayment at tax time.
What determines your eligibility for ACA Marketplace subsidies?