The Affordable Care Act and Your Taxes: What to Know in 2026

The Affordable Care Act (ACA) has been in effect since 2014, but the rules around subsidies, credits, and enrollment have changed significantly over the past several years (and again heading into 2026). This article covers what the ACA requires of taxpayers when filing, how the premium tax credit works, what forms you’ll need, and what changed for the 2026 coverage year. For the most current guidance, the IRS maintains a dedicated ACA resource for individuals – here.

Open enrollment for 2026 ACA marketplace coverage ran from November 1 through December 15, 2025. Special enrollment periods remain available for those who experience a qualifying life event such as job loss, marriage, or the birth of a child.

The individual mandate penalty (the fee for going without coverage) was effectively eliminated starting with tax year 2019 and remains at zero. If you don’t have qualifying health coverage in 2026, you will not owe a penalty on your federal tax return.

What Changed for 2026: Enhanced Premium Tax Credits Expired

The most significant ACA-related tax change for 2026 filers is the expiration of the enhanced premium tax credits that had been in place since 2021. Those enhanced credits, first created by the American Rescue Plan Act and later extended through 2025 by the Inflation Reduction Act, temporarily expanded eligibility for premium subsidies to households above 400% of the federal poverty level (FPL) and reduced costs across all income levels.

Those enhancements expired at the end of 2025. For the 2026 coverage year, premium tax credit eligibility returns to the original ACA structure: generally, households with incomes between 100% and 400% of the federal poverty level qualify for the credit. Households above 400% FPL are not eligible for the premium tax credit under current law.

The One Big Beautiful Bill Act also removed the repayment caps that had previously protected lower-income filers from having to repay large amounts of excess advance premium tax credits. Going forward, if you received more in advance premium tax credits than you were ultimately entitled to based on your actual income, you may be required to repay the full excess amount when you file (not just a capped portion). This makes it more important than ever to report income changes to the Marketplace promptly during the year.

APTC and the Premium Tax Credit

The Advanced Premium Tax Credit (APTC) is a federal subsidy available to individuals and families who purchase coverage through the Health Insurance Marketplace and whose household income falls between 100% and 400% of the federal poverty level. The credit helps pay part of a person or family’s health insurance premiums, and can be paid in advance directly to the insurer to reduce monthly premium costs.

If you received advance premium tax credits in 2026, you must file a federal income tax return and complete Form 8962, Premium Tax Credit, to reconcile the amount you received against what you were actually entitled to based on your final income for the year.

If at the end of the year you’ve taken more premium tax credit in advance than you’re due based on your final income, you’ll have to pay back the excess when you file your federal tax return. If you’ve taken less than you qualify for, you’ll get the difference back.

Because income estimates made at enrollment time may differ from actual year-end income, it’s important to report any significant income changes to the Marketplace as soon as they occur. This allows your advance credit to be adjusted mid-year, reducing the likelihood of a large repayment when you file.

Cost-Sharing Reductions

Cost-sharing reductions (CSRs) are a separate form of assistance that help reduce out-of-pocket costs such as deductibles and co-payments. CSRs are available to households with incomes up to 250% of the federal poverty level who purchase a silver plan through the Marketplace. Unlike the premium tax credit, CSRs are not reconciled on your tax return (they are applied directly to your plan’s cost structure).

CSRs were not affected by the expiration of the enhanced premium tax credits and remain available for 2026. However, because more filers are shifting to bronze plans in 2026 to offset rising premium costs, CSRs (which only apply to silver plans) may benefit fewer households than in prior years.

ACA Tax Forms You’ll Need

The IRS created three forms in the 1095 series to help taxpayers document their health coverage:

Form 1095-A is the Health Insurance Marketplace Statement. If you purchased coverage through the Marketplace, you’ll receive this form and must use it to complete Form 8962. Wait for your 1095-A before filing your return (you need the information it contains to calculate your premium tax credit accurately).

Form 1095-B is issued by your health insurance provider confirming that you had coverage meeting ACA standards. You don’t need this form to file, but it may be useful to have on hand.

Form 1095-C is issued by certain employers and provides details about employer-sponsored coverage offered to you. As with 1095-B, this form is informational and not required to file your return.

Form 8962 is used to calculate and claim the premium tax credit and to reconcile any advance payments made on your behalf. If you received APTC, you must file this form. Additional guidance on these forms can be found on the IRS ACA filing page – here.

Special Enrollment and Eligibility

The continuous special enrollment period for households with incomes below 150% of the federal poverty level was eliminated by the One Big Beautiful Bill Act. Starting in 2026, special enrollment periods are generally tied to qualifying life events (such as losing job-based coverage, getting married, having a child, or moving) rather than income level alone.

If you can provide proof to a health insurer that you had a major life event, you may be able to sign up through the special enrollment option. Be sure you have the required documentation when applying.

Note: Tax laws and ACA regulations may change with little notice. We do our best to keep this information current, but it is provided on an “AS IS” basis. For more, see our terms.