What is the 2026 ACA subsidy cliff in Pennsylvania?

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. Pennsylvania does not have a per-enrollee state premium subsidy backfill for 2026 — residents earning above the cliff receive no direct state premium assistance.

How do I enroll in 2026 coverage in Pennsylvania?

Pennsylvania uses Pennie at pennie.com. Open enrollment runs from November 1, 2025 through January 15, 2026 (Pennsylvania follows the standard federal deadline). Pennie also connects eligible residents to Medical Assistance (Medicaid) and CHIP. Outside open enrollment, enrollment requires a Special Enrollment Period (qualifying life event).

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

No per-enrollee state subsidy backfill exists for 2026. Pennsylvania operates a §1332 reinsurance program that reduces overall market premiums, which benefits all enrollees including those near the 400% FPL cliff — but it is a market-wide mechanism, not a direct household subsidy. Governor Shapiro proposed a state subsidy in FY 2026–27 budget discussions, but it had not been enacted as of this writing.

What is the Medicaid threshold in Pennsylvania?

Pennsylvania expanded Medicaid under the ACA. Adults with MAGI up to 138% FPL qualify for Medical Assistance (Pennsylvania's Medicaid program). Expansion was implemented in 2015 under Governor Wolf, replacing the prior modified HealthyPA program. Medical Assistance is administered by the Pennsylvania Department of Human Services.

How is SLCSP calculated for Pennsylvania?

The 2026 statewide SLCSP age-band averages for Pennsylvania are: Age 21: $420/mo, Age 30: $476/mo, Age 40: $537/mo, Age 50: $750/mo, Age 60: $1,140/mo. These are statewide averages; rates in Philadelphia, Pittsburgh, and rural areas may vary ±20–30%. 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 or Solo 401(k) for self-employed, capital-loss harvesting) can keep MAGI below 400% FPL. Pennsylvania has no state buffer above the cliff, making MAGI management particularly important for Pennsylvania residents near the 400% FPL boundary.

Pennsylvania Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated May 13, 2026

Pennsylvania Marketplace: Pennie

Pennsylvania uses a state-based marketplace (SBM) called Pennie. Pennsylvania residents enroll at Pennie — not HealthCare.gov.

Medicaid in Pennsylvania: Medical Assistance (Pennsylvania Medicaid)

Pennsylvania expanded Medicaid under the ACA. Medical Assistance (Pennsylvania Medicaid) covers adults to 138% FPL.

2026 SLCSP Benchmark Premiums (Pennsylvania)

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	$420	$476	$537	$750	$1,140

2026 ACA Cliff Thresholds by Household Size (Pennsylvania)

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: Pennsylvania ACA

Pennie is Pennsylvania's state-based marketplace, launched in 2020 when Pennsylvania transitioned from the federally-facilitated marketplace under Governor Wolf. As an SBM, Pennsylvania controls plan management and consumer assistance, but unlike several neighboring states (Connecticut, Massachusetts, New Jersey), Pennsylvania did not enact a per-enrollee state premium subsidy backfill for 2026.

Pennsylvania does operate a §1332 state innovation waiver for reinsurance — a program that pays a portion of high-cost claims for insurers, allowing them to lower overall market premiums. This benefits all enrollees including those near the 400% FPL cliff, but is not a direct subsidy to individual households. Governor Shapiro's FY 2026–27 budget proposal included state subsidy language in response to federal PTC expiration, but legislative action had not been completed as of this writing.

Medical Assistance (Pennsylvania's Medicaid) covers adults to 138% FPL under ACA expansion. Pennsylvania expanded Medicaid in 2015 under Governor Wolf, after an initial modified expansion under Governor Corbett (HealthyPA, 2014).

Calculate your Pennsylvania ACA cliff

Inputs default to Pennsylvania; 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: $1,464; $122 / 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

Pennie — Pennsylvania's Official Health Insurance Marketplace
“Welcome to Pennsylvania's Official Health Insurance Marketplace.”

FAQ — Pennsylvania ACA Cliff

What is the 2026 ACA subsidy cliff in Pennsylvania?: 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. Pennsylvania does not have a per-enrollee state premium subsidy backfill for 2026 — residents earning above the cliff receive no direct state premium assistance.
How do I enroll in 2026 coverage in Pennsylvania?: Pennsylvania uses Pennie at pennie.com. Open enrollment runs from November 1, 2025 through January 15, 2026 (Pennsylvania follows the standard federal deadline). Pennie also connects eligible residents to Medical Assistance (Medicaid) and CHIP. Outside open enrollment, enrollment requires a Special Enrollment Period (qualifying life event).
Does Pennsylvania have a state-funded subsidy on top of the federal PTC?: No per-enrollee state subsidy backfill exists for 2026. Pennsylvania operates a §1332 reinsurance program that reduces overall market premiums, which benefits all enrollees including those near the 400% FPL cliff — but it is a market-wide mechanism, not a direct household subsidy. Governor Shapiro proposed a state subsidy in FY 2026–27 budget discussions, but it had not been enacted as of this writing.
What is the Medicaid threshold in Pennsylvania?: Pennsylvania expanded Medicaid under the ACA. Adults with MAGI up to 138% FPL qualify for Medical Assistance (Pennsylvania's Medicaid program). Expansion was implemented in 2015 under Governor Wolf, replacing the prior modified HealthyPA program. Medical Assistance is administered by the Pennsylvania Department of Human Services.
How is SLCSP calculated for Pennsylvania?: The 2026 statewide SLCSP age-band averages for Pennsylvania are: Age 21: $420/mo, Age 30: $476/mo, Age 40: $537/mo, Age 50: $750/mo, Age 60: $1,140/mo. These are statewide averages; rates in Philadelphia, Pittsburgh, and rural areas may vary ±20–30%. 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 or Solo 401(k) for self-employed, capital-loss harvesting) can keep MAGI below 400% FPL. Pennsylvania has no state buffer above the cliff, making MAGI management particularly important for Pennsylvania residents near the 400% FPL boundary.

Glossary
Premium Tax Credit (PTC)
Glossary
MAGI
Glossary
Federal Poverty Level (FPL)
Glossary
Benchmark plan / SLCSP
Glossary
Medicaid expansion
State
New Jersey — NJHPS subsidy available
State
New York — neighboring SBM state