What is the income limit to qualify for Obamacare?

There is no single dollar cutoff. The limits are percentages of the federal poverty level, and your household size moves the line.

Updated September 3, 2026 · 3 min read · by Gerino Alejos

Key points

The limit is not one dollar amount, it is a percentage of the federal poverty level, and it moves with your household size.
Texas did not expand Medicaid, so some adults here earn too little for help and too much for Medicaid, which is called the coverage gap.
The dollar figures reset every year, so check your own household at HealthCare.gov or call us at (956) 687 3334 before you decide.

People ask about the income limit as if there were one cutoff. There are two, a lower boundary and an upper one, and both are set as a percentage of the federal poverty level rather than a flat dollar amount. In Texas the lower one causes far more trouble.

How the limits are expressed

The rules are written as a percentage of the federal poverty level, an income figure the government sets each year by household size. The percentages are the law and they hold steady. The dollar amounts behind them move every year, which is why you will not find them printed here.

Household size matters as much as income. The same pay can sit inside the range for a family of five and outside it for one person living alone. Add a person to the household and the dollar line for that same percentage moves up.

The lower boundary, which is the Texas problem

Help with the bill comes as a premium tax credit, money that lowers your premium, the monthly bill for the plan. Most people call it a subsidy. It was built to begin where Medicaid was expected to end.

Medicaid is the state and federal program for people with low income. Texas did not expand it, so for adults there is a gap between the two programs.

Someone who earns below the point where the credit starts, and who does not fit one of Texas Medicaid's narrow categories, can qualify for neither program. That is the coverage gap, and it affects real people here.

If you were told your income is too low for help, do not walk away. How your income is counted, and how it is projected for the coming year, can change the answer. Self employment income in particular is often estimated wrong. That is worth a conversation.

See the coverage gap in Texas.

The upper boundary

There has long been an upper line as well, and above it no credit was available. Rules in this area have changed over recent years and can change again. So the advice stays the same no matter where the line sits right now.

Check what you qualify for instead of assuming you earn too much. People who expected to be well past the line have still received real help, especially older applicants and larger households. The credit is figured against what coverage costs, not against income alone.

The figure that is used

It is not your gross pay, and it is not last year's tax return. It is your modified adjusted gross income for the coverage year, counted for your whole tax household. Your tax household is everyone you claim on your return.

Count everyone you claim on your tax return, even if they will not be on the plan.
Estimate the coming year, not the one that just ended.
For self employment, use your income after business expenses.
Include the untaxed part of Social Security benefits, which surprises people.

If your income changes

Report it to the Marketplace when it happens, not later. The Marketplace is the government site where these plans are sold. Your credit adjusts going forward, and you avoid a rough surprise at tax time.

A raise you never reported means paying back part of the credit. A drop you never reported means you paid more all year than you had to.

How to check

Enter your household size and your estimated income at HealthCare.gov. It will show you what you would pay. Looking commits you to nothing.

The poverty level figures update every year and the rules keep shifting. We would rather run current numbers with you than print thresholds here that go stale. See the full eligibility rules.

Write down your household size and your closest estimate of next year's income, then have someone check them against the current limits. Call our McAllen office at (956) 687 3334, or enter your ZIP code in the box on this page.

Common follow-up questions

What if my income is too low?

In Texas you may land in the coverage gap, since Medicaid was not expanded here. How your income is counted and projected can change the answer, so it is worth a look before you assume.

Does my spouse's income count?

Yes. The whole tax household is counted, including people who will not be on the plan.

What if I do not know what I will earn?

Estimate as closely as you can, then tell the Marketplace when it changes. Self employed applicants should look at it again during the year.

Want this looked at properly?

We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. There is no obligation to talk it through.

Call (956) 687 3334

Se habla español