Congress is currently debating whether to extend the enhanced premium tax credits (PTCs) past their scheduled December 31, 2025 expiration date. If the enhanced credits are not extended, the system will revert to the original Affordable Care Act formula, which limits the amount an individual or family pays for the benchmark plan—the second-lowest-cost Silver plan available in the Marketplace—to a specific percentage of household income.
The difference between the benchmark plan’s total premium and the household’s capped contribution becomes the premium tax credit (PTC). This credit can be applied toward any Marketplace plan—Bronze, Silver, Gold, or Platinum. Families choosing a lower-cost plan may pay less than the capped amount, while those selecting a higher-cost plan would pay the difference above the cap.
The chart below shows, for various household sizes and income levels (as a multiple of the Federal Poverty Level, or FPL), the estimated annual income, the annual cap on what that household would pay for the benchmark plan, and the equivalent monthly cap. These caps represent the most a family would pay for the benchmark plan if the enhanced PTCs are not extended.
| Household Size | 100% FPL 2.07% cap |
133% FPL 3.10% cap |
150% FPL 4.14% cap |
200% FPL 6.52% cap |
250% FPL 8.33% cap |
300% FPL 9.83% cap |
400% FPL 9.83% cap |
|---|---|---|---|---|---|---|---|
| 1 | $15,650 Cap: $324/yr $27/mo | $20,814 Cap: $645/yr $54/mo | $23,475 Cap: $972/yr $81/mo | $31,300 Cap: $2,041/yr $170/mo | $39,125 Cap: $3,259/yr $272/mo | $46,950 Cap: $4,616/yr $385/mo | $62,600 Cap: $6,154/yr $513/mo |
| 2 | $21,150 Cap: $438/yr $37/mo | $28,130 Cap: $872/yr $73/mo | $31,725 Cap: $1,313/yr $109/mo | $42,300 Cap: $2,758/yr $230/mo | $52,875 Cap: $4,404/yr $367/mo | $63,450 Cap: $6,237/yr $520/mo | $84,600 Cap: $8,316/yr $693/mo |
| 3 | $26,650 Cap: $552/yr $46/mo | $35,444 Cap: $1,099/yr $92/mo | $39,975 Cap: $1,655/yr $138/mo | $53,300 Cap: $3,475/yr $290/mo | $66,625 Cap: $5,550/yr $462/mo | $79,950 Cap: $7,859/yr $655/mo | $106,600 Cap: $10,479/yr $873/mo |
| 4 | $32,150 Cap: $666/yr $55/mo | $42,760 Cap: $1,326/yr $110/mo | $48,225 Cap: $1,997/yr $166/mo | $64,300 Cap: $4,192/yr $349/mo | $80,375 Cap: $6,695/yr $558/mo | $96,450 Cap: $9,481/yr $790/mo | $128,600 Cap: $12,641/yr $1,053/mo |
| 5 | $37,650 Cap: $779/yr $65/mo | $50,074 Cap: $1,552/yr $129/mo | $56,475 Cap: $2,338/yr $195/mo | $75,300 Cap: $4,910/yr $409/mo | $94,125 Cap: $7,841/yr $653/mo | $112,950 Cap: $11,103/yr $925/mo | $150,600 Cap: $14,804/yr $1,234/mo |
| 6 | $43,150 Cap: $893/yr $74/mo | $57,390 Cap: $1,779/yr $148/mo | $64,725 Cap: $2,680/yr $223/mo | $86,300 Cap: $5,627/yr $469/mo | $107,875 Cap: $8,986/yr $749/mo | $129,450 Cap: $12,725/yr $1,060/mo | $172,600 Cap: $16,967/yr $1,414/mo |
| 7 | $48,650 Cap: $1,007/yr $84/mo | $64,704 Cap: $2,006/yr $167/mo | $72,975 Cap: $3,021/yr $252/mo | $97,300 Cap: $6,344/yr $529/mo | $121,625 Cap: $10,131/yr $844/mo | $145,950 Cap: $14,347/yr $1,196/mo | $194,600 Cap: $19,129/yr $1,594/mo |
| 8 | $54,150 Cap: $1,121/yr $93/mo | $72,020 Cap: $2,233/yr $186/mo | $81,225 Cap: $3,363/yr $280/mo | $108,300 Cap: $7,061/yr $588/mo | $135,375 Cap: $11,277/yr $940/mo | $162,450 Cap: $15,969/yr $1,331/mo | $216,600 Cap: $21,292/yr $1,774/mo |
Caps represent the maximum household contribution toward the benchmark SLCSP. Premium Tax Credit (PTC) = Benchmark premium − Annual Cap (floored at $0). Applies to 48 states + DC (Alaska and Hawaii differ).