What is the 2026 ACA subsidy cliff in North Carolina?

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. North Carolina has no state subsidy backfill, so crossing this threshold eliminates all premium assistance.

When did North Carolina expand Medicaid?

North Carolina's Medicaid expansion took effect December 1, 2023, under HB 76 enacted in the 2023 legislative session. NC became the 41st state to expand Medicaid under the ACA, ending a long political standoff. Expansion covers adults earning up to 138% FPL ($22,597 for a single adult in 2026) who do not already qualify for traditional Medicaid.

How do I enroll in marketplace coverage in North Carolina?

North Carolina uses HealthCare.gov (the federal FFM marketplace). Open enrollment runs November 1 through January 15. You can also apply for NC Medicaid at ncdhhs.gov or through a local Department of Social Services office. HealthCare.gov screens for Medicaid eligibility automatically during marketplace applications.

Does North Carolina have a state subsidy on top of the federal PTC?

No. North Carolina has no state-funded premium subsidy backfill for 2026. Residents rely entirely on federal APTC, which ends above 400% FPL ($62,600 for HH=1). The American Rescue Plan enhanced PTCs expired December 31, 2025.

What is the NC Medicaid threshold?

Following the 2023 expansion, NC Medicaid covers adults to 138% FPL ($22,597 for a single adult in 2026). NC Medicaid also covers children and pregnant women at higher income levels. Enrollment in NC Medicaid is administered by NC DHHS through managed care health plans.

How is SLCSP calculated for North Carolina?

The 2026 statewide SLCSP age-band averages for North Carolina are: Age 21: $470/mo, Age 30: $533/mo, Age 40: $600/mo, Age 50: $838/mo, Age 60: $1,273/mo. These are statewide averages; your specific county may vary ±20–30%. 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 North Carolina?

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. Because North Carolina has no state subsidy above 400% FPL, staying below the federal cliff has full dollar impact.

North Carolina Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated May 13, 2026

North Carolina Marketplace: HealthCare.gov

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

Medicaid in North Carolina: NC Medicaid

North Carolina expanded Medicaid under the ACA. NC Medicaid covers adults to 138% FPL.

2026 SLCSP Benchmark Premiums (North Carolina)

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	$470	$533	$600	$838	$1,273

2026 ACA Cliff Thresholds by Household Size (North Carolina)

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: North Carolina ACA

North Carolina made a significant health coverage change in 2023: Medicaid expansion went into effect on December 1, 2023, making NC the 41st state to expand Medicaid under the ACA. The expansion was authorized by HB 76 in the 2023 legislative session, resolving a long political deadlock that had kept hundreds of thousands of low-income North Carolinians without coverage options. Prior to expansion, NC had one of the larger coverage gaps in the Southeast.

NC Medicaid (administered by NC DHHS) now covers adults earning up to 138% FPL. Enrollment in the first year of expansion exceeded initial projections. The expansion retroactively closed the coverage gap for adults who had been in the 100-138% FPL band with no subsidized coverage pathway.

North Carolina uses HealthCare.gov (FFM) for marketplace enrollment and has not enacted any state-funded premium subsidy backfill for 2026. The enhanced PTCs under the American Rescue Plan expired December 31, 2025, and NC residents above 400% FPL receive no premium assistance in 2026.

Calculate your North Carolina ACA cliff

Inputs default to North Carolina; 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: $2,220; $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

NC DHHS — Medicaid Expansion
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FAQ — North Carolina ACA Cliff

What is the 2026 ACA subsidy cliff in North Carolina?: 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. North Carolina has no state subsidy backfill, so crossing this threshold eliminates all premium assistance.
When did North Carolina expand Medicaid?: North Carolina's Medicaid expansion took effect December 1, 2023, under HB 76 enacted in the 2023 legislative session. NC became the 41st state to expand Medicaid under the ACA, ending a long political standoff. Expansion covers adults earning up to 138% FPL ($22,597 for a single adult in 2026) who do not already qualify for traditional Medicaid.
How do I enroll in marketplace coverage in North Carolina?: North Carolina uses HealthCare.gov (the federal FFM marketplace). Open enrollment runs November 1 through January 15. You can also apply for NC Medicaid at ncdhhs.gov or through a local Department of Social Services office. HealthCare.gov screens for Medicaid eligibility automatically during marketplace applications.
Does North Carolina have a state subsidy on top of the federal PTC?: No. North Carolina has no state-funded premium subsidy backfill for 2026. Residents rely entirely on federal APTC, which ends above 400% FPL ($62,600 for HH=1). The American Rescue Plan enhanced PTCs expired December 31, 2025.
What is the NC Medicaid threshold?: Following the 2023 expansion, NC Medicaid covers adults to 138% FPL ($22,597 for a single adult in 2026). NC Medicaid also covers children and pregnant women at higher income levels. Enrollment in NC Medicaid is administered by NC DHHS through managed care health plans.
How is SLCSP calculated for North Carolina?: The 2026 statewide SLCSP age-band averages for North Carolina are: Age 21: $470/mo, Age 30: $533/mo, Age 40: $600/mo, Age 50: $838/mo, Age 60: $1,273/mo. These are statewide averages; your specific county may vary ±20–30%. 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 North Carolina?: 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. Because North Carolina has no state subsidy above 400% FPL, staying below the federal cliff has full dollar impact.

Glossary
Premium Tax Credit (PTC)
Glossary
MAGI
Glossary
Federal Poverty Level (FPL)
Glossary
Benchmark plan / SLCSP
Glossary
Medicaid expansion
State
South Carolina — non-expansion neighbor
State
Virginia — expanded Medicaid 2019