Globalcare ConsultingACA marketplace · NJ · NY · GA
ACA/Individual & Family Health Insurance
The ACA marketplace is where individuals and families buy their own health coverage — self-employed, between jobs, early retirees, or anyone whose employer doesn’t offer a plan. Every plan covers the same ten essential health benefits, and financial help is based on your income. But 2026 changed the math, and it’s worth understanding before you shop.
Where that help cuts off depends on household size — roughly $84,600 for a couple, or $128,600 for a family of four.
The subsidy cliff is back.
The enhanced premium tax credits that ran from 2021 through 2025 expired at the end of 2025. For 2026, financial help stops entirely above 400% of the federal poverty level — roughly $62,600 for an individual. Congress has debated an extension, but nothing has been enacted. If your income is near that line, the difference of a single dollar can be worth thousands.
And if your income lands just above that line, don’t assume the door is closed — in many cases we can help you find a path back under the threshold. It’s worth a quick conversation before you rule out the marketplace.
Who buys coverage here
If you have affordable employer coverage, Medicare, or Medicaid, the marketplace usually isn't for you. Otherwise, it likely is.
Families & individuals
Anyone whose employer offers no plan, or a plan deemed unaffordable.
Self-employed & contractors
Freelancers, gig workers, and small business owners without a group plan.
Lost Medicaid coverage
Losing Medicaid — often after an eligibility redetermination or a change in income — opens a Special Enrollment Period to move onto a marketplace plan.
Between jobs
Lost employer coverage — often an alternative to expensive COBRA.
The four metal tiers
Every tier covers the same essential health benefits. What changes is the split between what you pay monthly and what you pay when you use care.
Bronze
Lowest monthly cost, highest deductible and out-of-pocket costs. Suits people who rarely need care.
Silver
Moderate premium and cost sharing. The only tier that unlocks cost-sharing reductions.
Gold
Higher premium, lower costs when you use care. Suits frequent medical visits.
Platinum
Highest premium, lowest out-of-pocket. Availability varies by state and carrier.
The Silver trap
If your income is under 250% of the poverty level, choosing Silver unlocks cost-sharing reductions — lower deductibles and copays that can make a Silver plan behave more like Gold. Those reductions attach to Silver only. In 2026 many people dropped to Bronze to cut their premium and unknowingly gave up that benefit. It’s a real trade-off, and worth running the numbers on.
Not sure whether you’d qualify for those cost-sharing reductions — or which tier actually leaves you better off? We can run the numbers with you and help you determine your eligibility.
Your state runs its own marketplace
None of the three states we serve send you to HealthCare.gov. Each has its own platform — and its own rules about who gets help.
Get Covered New Jersey
New Jersey adds its own state subsidy on top of federal credits, reaching households well above the federal cutoff. It also has an individual mandate with a state tax penalty.
NY State of Health
New York offers the Essential Plan — low-cost comprehensive coverage with year-round enrollment for those who qualify — alongside standard marketplace plans.
Georgia Access
Georgia hasn’t expanded Medicaid, which leaves a coverage gap below the poverty line. Knowing whether you fall into it — or into Pathways — changes everything.