Florida Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated

Florida Marketplace: HealthCare.gov

Florida uses a federally-facilitated marketplace (FFM) called HealthCare.gov. Florida residents enroll at HealthCare.gov.

Medicaid in Florida: Florida Medicaid (Statewide Medicaid Managed Care, SMMC)

Florida has not expanded Medicaid under the ACA. Adults above the pre-ACA income limit and below 100% FPL may fall into a coverage gap — they earn too little to qualify for marketplace subsidies (which start at 100% FPL) but do not qualify for Medicaid.

2026 SLCSP Benchmark Premiums (Florida)

Statewide average monthly second-lowest-cost Silver plan (SLCSP) premiums by age. Actual premiums vary by rating area.

Age2130405060
Monthly SLCSP$470$533$600$838$1,273

2026 ACA Cliff Thresholds by Household Size (Florida)

MAGI above these amounts zeros out the federal Premium Tax Credit. FPL region: contiguous48.

Household size12345
400% FPL cliff$62,600$84,600$106,600$128,600$150,600

Key Facts: Florida ACA

Florida is the largest ACA marketplace state by enrollment, with approximately 4.2 million residents enrolled in plan year 2025 — more than any other state. This exceptional enrollment is partly structural: because Florida has not expanded Medicaid, middle-income Floridians who might otherwise cycle between Medicaid and marketplace coverage are pushed toward marketplace plans for any coverage at all. High enrollment does not, however, solve Florida's coverage gap problem.

Florida also has the largest absolute coverage gap population in the United States, with an estimated 415,000 adults earning between 100% and 138% FPL who are ineligible for both Florida Medicaid and federal marketplace PTCs. KFF reports that Florida and Georgia together account for 19% of the national coverage gap population. Florida's non-expansion stance has been challenged repeatedly in the legislature but has not changed as of 2026.

Florida has enacted no state-funded premium subsidy backfill for 2026. The expiration of enhanced PTCs on December 31, 2025 created a significant premium shock for Florida's large marketplace population. Residents use HealthCare.gov (FFM) for enrollment; all plan certification and consumer protections flow through the federal government.

Calculate your Florida ACA cliff

Inputs default to Florida; adjust to your household specifics. Cliff = $62,600 (HH=1) / $128,600 (HH=4).

Your situation

Member ages
self

Coverage

Income

You're under the cliff

100%138%200%300%400%

You are at 319% of the federal poverty level.

Annual PTC
$2,220
$185 / month
MAGI headroom before cliff
$12,600
until you hit 400% FPL

PTC dollar values use a state-level SLCSP estimate; verify your exact second-lowest-cost Silver plan on healthcare.gov for your zip.

Primary Sources

  1. KFF — The Coverage Gap: Uninsured Poor Adults in Non-Expansion States
    “Florida and Georgia account for an additional 19% and 14%, respectively”

FAQ — Florida ACA Cliff

What is the 2026 ACA subsidy cliff in Florida?
For a household of 1, MAGI above $62,600 (400% of the 2025 FPL contiguous-48 base) zeros out the federal Premium Tax Credit under IRS Rev. Proc. 2025-25. Household of 4: $128,600. Florida has no state subsidy backfill, so crossing this threshold eliminates all premium assistance.
Why does Florida have so many ACA marketplace enrollees?
Florida leads the nation in marketplace enrollment (~4.2M in PY 2025) partly because it has not expanded Medicaid. Without Medicaid expansion, working adults who earn modest incomes must turn to the marketplace for subsidized coverage rather than Medicaid. Florida's large population and many self-employed and gig workers also contribute to high enrollment.
What is the coverage gap in Florida?
Approximately 415,000 Florida adults fall into the coverage gap — they earn between 100% and 138% FPL, making them ineligible for Florida Medicaid (which doesn't cover most non-disabled adults without dependents) and technically in the PTC-eligible range but extremely vulnerable. Below 100% FPL, residents cannot receive PTCs at all. Florida has the largest coverage gap population in the US.
How do I enroll in marketplace coverage in Florida?
Florida uses HealthCare.gov (the federal FFM marketplace). Open enrollment runs November 1 through January 15. Florida does not have a state-based marketplace. Navigators and enrollment assisters operate across Florida; call 1-800-318-2596 for healthcare.gov assistance.
Does Florida have a state subsidy on top of the federal PTC?
No. Florida has no state-funded premium subsidy backfill for 2026. Residents rely entirely on federal APTC, which ends above 400% FPL. The enhanced PTCs from the American Rescue Plan expired December 31, 2025, resulting in higher marketplace premiums for many Florida enrollees in 2026.
How is SLCSP calculated for Florida?
The 2026 statewide SLCSP age-band averages for Florida are: Age 21: $470/mo, Age 30: $533/mo, Age 40: $600/mo, Age 50: $838/mo, Age 60: $1,273/mo. Florida has wide regional variation; South Florida and Miami-Dade are higher than statewide averages. The federal cliff distance (income vs. 400% FPL) is exact regardless of SLCSP precision.
Can I reduce my MAGI to stay below the 2026 cliff in Florida?
Yes — common strategies include maximizing HSA contributions, deductible IRA or SEP-IRA/Solo 401(k) contributions if self-employed, harvesting capital losses, and deferring Roth conversions. Florida has no state income tax, which simplifies some planning. Because Florida has no state subsidy above 400% FPL, the federal cliff has full dollar impact for Florida residents.

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