What is the 2026 ACA subsidy cliff in New York?

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. New York's state CSR supplement under §1332 waiver extends cost-sharing reductions through 400% FPL, providing some benefit below the cliff. Above 400% FPL, no state premium subsidy applies.

What is the Essential Plan change on July 1, 2026?

New York's Essential Plan is a §1331 Basic Health Program providing $0-premium coverage. Through June 30, 2026, eligibility extends to 250% FPL. Effective July 1, 2026, NY is reducing eligibility to 200% FPL. Households at 200–250% FPL enrolled in the Essential Plan will need to transition to a QHP with federal PTC — they should watch for transition notices from NY State of Health.

How do I enroll in 2026 coverage in New York?

New York uses NY State of Health at nystateofhealth.ny.gov. Open enrollment runs from November 1, 2025 through January 31, 2026 (NY extends beyond the federal deadline). The NYSOH platform integrates enrollment for Medicaid, Essential Plan, Child Health Plus, and QHPs in a single application. Outside open enrollment, enrollment requires a Special Enrollment Period.

Does New York have a state-funded subsidy on top of the federal PTC?

Yes — two mechanisms. The Essential Plan (§1331 BHP) provides $0-premium coverage for adults at 138–200% FPL (through H1 2026). The state CSR supplement under a §1332 waiver extends cost-sharing reductions on Silver QHPs to enrollees at up to 400% FPL, beyond the federal 250% FPL CSR cap. There is no state premium subsidy above 400% FPL for 2026.

What is the Medicaid threshold in New York?

New York expanded Medicaid under the ACA. Adults with MAGI up to 138% FPL qualify for New York Medicaid. Above 138% FPL, New York's Essential Plan (§1331 BHP) covers 138–200% FPL with $0 premiums. Above 200% FPL (or 250% FPL until July 1, 2026), residents qualify for QHPs with federal PTC.

How is SLCSP calculated for New York?

The 2026 statewide SLCSP age-band averages for New York are: Age 21: $510/mo, Age 30: $578/mo, Age 40: $651/mo, Age 50: $909/mo, Age 60: $1,382/mo. These are statewide averages; NYC rates differ significantly from upstate rates. The cliff distance (income vs. 400% FPL) is exact regardless of SLCSP precision.

Can I avoid the 2026 cliff by reducing my MAGI?

Yes — MAGI-reduction strategies (HSA contributions, deductible IRA, SEP-IRA for self-employed, capital-loss harvesting) can keep income below 400% FPL to preserve the federal PTC. In New York, the state CSR supplement continues to provide cost-sharing reduction up to 400% FPL on Silver plans, so staying below 400% FPL also preserves that benefit.

New York Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated May 13, 2026

New York Marketplace: NY State of Health

New York uses a state-based marketplace (SBM) called NY State of Health. New York residents enroll at NY State of Health — not HealthCare.gov.

Medicaid in New York: New York Medicaid

New York expanded Medicaid under the ACA. New York Medicaid covers adults to 138% FPL.

State Subsidy Backfill

Two mechanisms: (1) Essential Plan (§1331 BHP) provides $0-premium coverage for 138-200% FPL (eligibility cut from 250% to 200% FPL on July 1, 2026). (2) State CSR Supplement under §1332 waiver extends cost-sharing reductions to QHP enrollees up to 400% FPL (funding status uncertain in H2 2026).

2026 SLCSP Benchmark Premiums (New York)

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

Age	21	30	40	50	60
Monthly SLCSP	$510	$578	$651	$909	$1,382

2026 ACA Cliff Thresholds by Household Size (New York)

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

Household size	1	2	3	4	5
400% FPL cliff	$62,600	$84,600	$106,600	$128,600	$150,600

Key Facts: New York ACA

New York has the largest state-based marketplace by enrollment and one of the most complex subsidy architectures in the country. The Essential Plan, operating under a federal §1331 Basic Health Program authorization, provides $0-premium coverage to adults at 138–250% FPL — funded by federal pass-through dollars. However, New York is reducing Essential Plan eligibility from 250% FPL to 200% FPL effective July 1, 2026, a major mid-year change that will shift households at 200–250% FPL into QHP coverage with standard PTC instead.

New York also maintains a state Cost-Sharing Reduction (CSR) supplement through a §1332 waiver that extends cost-sharing reductions to QHP enrollees up to 400% FPL — beyond the federal CSR cap of 250% FPL. This is distinct from the federal CSR program and represents meaningful cost-sharing relief for households between 250% and 400% FPL on Silver plans. The funding status of this supplement for H2 2026 is uncertain as of this writing.

New York Medicaid covers adults to 138% FPL, and the NYSOH platform integrates enrollment pathways for Medicaid, the Essential Plan, Child Health Plus (CHIP), and QHPs in a single application flow.

Calculate your New York ACA cliff

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

Your situation

Household size

State

Filing status

Member ages

selftobacco

Coverage

One or more members have employer-sponsored coverage offered

Income

Wages (W-2)

You're under the cliff

100%138%200%300%400%

You are at 319% of the federal poverty level.

Annual PTC: $2,832; $236 / 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

NY State of Health — Essential Plan
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NY State of Health — State CSR Supplement (§1332 waiver attachment)
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FAQ — New York ACA Cliff

What is the 2026 ACA subsidy cliff in New York?: 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. New York's state CSR supplement under §1332 waiver extends cost-sharing reductions through 400% FPL, providing some benefit below the cliff. Above 400% FPL, no state premium subsidy applies.
What is the Essential Plan change on July 1, 2026?: New York's Essential Plan is a §1331 Basic Health Program providing $0-premium coverage. Through June 30, 2026, eligibility extends to 250% FPL. Effective July 1, 2026, NY is reducing eligibility to 200% FPL. Households at 200–250% FPL enrolled in the Essential Plan will need to transition to a QHP with federal PTC — they should watch for transition notices from NY State of Health.
How do I enroll in 2026 coverage in New York?: New York uses NY State of Health at nystateofhealth.ny.gov. Open enrollment runs from November 1, 2025 through January 31, 2026 (NY extends beyond the federal deadline). The NYSOH platform integrates enrollment for Medicaid, Essential Plan, Child Health Plus, and QHPs in a single application. Outside open enrollment, enrollment requires a Special Enrollment Period.
Does New York have a state-funded subsidy on top of the federal PTC?: Yes — two mechanisms. The Essential Plan (§1331 BHP) provides $0-premium coverage for adults at 138–200% FPL (through H1 2026). The state CSR supplement under a §1332 waiver extends cost-sharing reductions on Silver QHPs to enrollees at up to 400% FPL, beyond the federal 250% FPL CSR cap. There is no state premium subsidy above 400% FPL for 2026.
What is the Medicaid threshold in New York?: New York expanded Medicaid under the ACA. Adults with MAGI up to 138% FPL qualify for New York Medicaid. Above 138% FPL, New York's Essential Plan (§1331 BHP) covers 138–200% FPL with $0 premiums. Above 200% FPL (or 250% FPL until July 1, 2026), residents qualify for QHPs with federal PTC.
How is SLCSP calculated for New York?: The 2026 statewide SLCSP age-band averages for New York are: Age 21: $510/mo, Age 30: $578/mo, Age 40: $651/mo, Age 50: $909/mo, Age 60: $1,382/mo. These are statewide averages; NYC rates differ significantly from upstate rates. The cliff distance (income vs. 400% FPL) is exact regardless of SLCSP precision.
Can I avoid the 2026 cliff by reducing my MAGI?: Yes — MAGI-reduction strategies (HSA contributions, deductible IRA, SEP-IRA for self-employed, capital-loss harvesting) can keep income below 400% FPL to preserve the federal PTC. In New York, the state CSR supplement continues to provide cost-sharing reduction up to 400% FPL on Silver plans, so staying below 400% FPL also preserves that benefit.