Published October 26, 2026 · Daniel Griffin, Licensed Independent Advisor · NPN #22052447
Short answer: six figures that decide what a self-employed household pays for health insurance moved for 2027, and all six are now set: the tax-credit line ($63,840 for one person), the most anyone pays for a benchmark plan (10.22% of income), the out-of-pocket ceiling ($12,000), the HSA limit ($4,500), the cap on paying back extra credit (gone), and your state’s approved rate increase. Open Enrollment runs November 1 to January 15, and December 15 is the date that gets you a January 1 start.
1. The Tax-Credit Line: $63,840 for One Person
For 2027 coverage there is no premium tax credit above 400% of the federal poverty level. The enhanced credits that reached above that line expired at the end of 2025, so one dollar over means no credit at all.
| Household | No credit above |
|---|---|
| 1 person | $63,840 |
| 2 people | $86,560 |
| 3 people | $109,280 |
| 4 people | $132,000 |
400% of the 2026 HHS poverty guidelines ($15,960 for one person, plus $5,680 for each additional person), which govern 2027 coverage.
For a self-employed household the number that counts is modified adjusted gross income: net profit after half of self-employment tax, retirement contributions and HSA deposits come off. That is why the line is closer than it looks (what one dollar over costs a family).
2. 10.22% of Income Is the Most a Benchmark Plan Costs You
Below the line, your credit is sized so the benchmark Silver plan costs you a set share of income. For 2027 that share tops out at 10.22% between 300% and 400% of poverty, up from 10.22% in 2027. A single owner expecting $60,000 would pay about $6,132 a year, or $511 a month, for the benchmark plan. At the bottom of the scale the share is 2.15%.
3. The Out-of-Pocket Ceiling Is $12,000
The most a marketplace plan can make one person pay in a year for covered in-network care rose to $12,000 ($24,000 for a family), from $10,600 and $21,200 in 2026. Two plans with similar premiums can now differ by thousands in a bad year (why the ceiling jumped).
4. HSA Limit $4,500, and Every Bronze Plan Qualifies
You can put $4,500 into a health savings account for 2027, or $9,000 with family coverage, plus $1,000 more from age 55. Since January 2026 every bronze and catastrophic plan sold on the marketplace, and the identical plan bought off it, counts as HSA-eligible. The deposit comes off your income, so it also moves you further under the tax-credit line.
Self-employed and close to $63,840?
Send your ZIP code. A licensed agent works out where your 2027 income lands against the line and what a bronze-plus-HSA setup changes.
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5. No Cap on Paying Back Extra Credit
From the 2026 tax year, anyone who received more advance credit than their final income allows repays all of it. Before 2026 the repayment was capped for incomes under 400% of poverty. For a self-employed owner whose income is hard to predict, a low guess in November now becomes a full bill in April.
6. Your State’s Rate Increase Is Final, in Most States
As of October 20, regulators had signed off on 2027 individual-market rates in 15 of the 23 states covered here, with average increases from 7.4% in Utah to 22.1% in South Carolina. Arkansas, Kansas, Mississippi, Nebraska, North Carolina, Oklahoma, Texas and Wisconsin had not finalized (all 23 states ranked).
What to Do Before December 15
- Estimate 2027 income from your last return and this year’s trend, not from last year alone.
- Decide on an HSA before you pick the plan, since only bronze and catastrophic plans qualify without a high deductible.
- For each plan, add twelve months of premium to its out-of-pocket maximum: that is your worst year.
More for owners and freelancers is on the self-employed guide.
Want the six numbers run for your household?
Send your ZIP code. A licensed agent lines up marketplace and private options against your 2027 income before December 15.
Get Started Right Now →Free · No obligation · Licensed in 23 states · NPN #22052447
Sources
- HHS, 2026 poverty guidelines: the 400% line for 2027 coverage.
- IRS, Rev. Proc. 2026-26: the 2027 applicable percentages, 2.15% to 10.22%.
- CMS, 2027 premium adjustment and cost-sharing guidance: the $12,000 out-of-pocket limit.
- IRS, Rev. Proc. 2026-24: 2027 HSA contribution limits.
- IRS, Notice 2026-5, Q&A-4 and Q&A-6: bronze and catastrophic plans treated as HSA-eligible.
- IRS, Questions and Answers on the Premium Tax Credit: no repayment cap from the 2026 tax year.
- HealthCare.gov, dates and deadlines.
Nothing here is tax advice; confirm income and credit decisions with your tax preparer. Rate figures are state averages; your own premium depends on age, county and plan. Daniel Griffin is a licensed independent insurance agent, NPN #22052447, not tied to any single carrier and not affiliated with the U.S. government.