If you live in Idaho and need health insurance, the Affordable Care Act (ACA) marketplace may offer coverage at a reduced cost through premium tax credits. Idaho runs its own state-based marketplace called Your Health Idaho, where residents can shop for plans, compare prices, and enroll in coverage. For 2026, eligibility rules have shifted because the enhanced subsidies that were in place from 2021 through 2025 have expired. This guide breaks down exactly who qualifies, what income limits apply, and how to sign up.
Not sure if ACA coverage is the right fit? Check your eligibility for all available benefits with our free screening tool. You can also explore additional programs on our Idaho Benefits Overview page.
What Is Your Health Idaho?
Your Health Idaho is the state's official health insurance marketplace. It is the only place where Idaho residents can access federal premium tax credits to lower their monthly insurance costs. The marketplace offers 154 medical plans and 21 dental plans from multiple insurance companies. Every plan covers ten essential health benefits including doctor visits, hospitalization, prescriptions, preventive care, and mental health services.
Unlike states that use the federal HealthCare.gov platform, Idaho manages its own enrollment system. That means you apply, shop, and enroll directly through yourhealthidaho.org.
Who Is Eligible for ACA Coverage in Idaho?
To qualify for a marketplace plan through Your Health Idaho, you must meet all of the following requirements:
- Idaho resident. You must live in Idaho.
- U.S. citizen or lawfully present immigrant. Undocumented immigrants are not eligible for marketplace coverage.
- Not incarcerated. Individuals currently in jail or prison cannot enroll.
- Not eligible for premium-free Medicare Part A. If you already have Medicare, you cannot purchase a marketplace plan.
Meeting these requirements makes you eligible to buy a plan on the marketplace. However, qualifying for premium tax credits (subsidies) to lower your costs depends on your household income.
2026 Income Limits for ACA Subsidies in Idaho
Premium tax credits are available to Idaho residents with household incomes between 138% and 400% of the Federal Poverty Level (FPL). If your income falls below 138% FPL, you likely qualify for Idaho Medicaid instead. If your income exceeds 400% FPL, you can still buy a marketplace plan but will pay the full unsubsidized premium.
These income limits reflect a major change from the previous few years. From 2021 through 2025, enhanced subsidies removed the 400% FPL cap entirely, meaning even higher earners could receive assistance. Congress did not extend those enhanced credits, so the original 400% FPL cap is back in effect for 2026.
Here are the 2026 income ranges for ACA subsidy eligibility in Idaho, based on the 2026 Federal Poverty Level guidelines:
| Household Size | Medicaid (Below 138% FPL) | ACA Subsidy Range (138% to 400% FPL) | No Subsidy (Above 400% FPL) |
|---|---|---|---|
| 1 person | Below $22,025 | $22,025 to $63,840 | Above $63,840 |
| 2 people | Below $29,863 | $29,863 to $86,560 | Above $86,560 |
| 3 people | Below $37,702 | $37,702 to $109,280 | Above $109,280 |
| 4 people | Below $45,540 | $45,540 to $132,000 | Above $132,000 |
| 5 people | Below $53,378 | $53,378 to $154,720 | Above $154,720 |
| 6 people | Below $61,217 | $61,217 to $177,440 | Above $177,440 |
Income figures are based on Modified Adjusted Gross Income (MAGI). The 2026 FPL for a single individual is $15,960, with $5,680 added for each additional household member. Amounts shown are approximate and rounded.
How Premium Tax Credits Work in 2026
Premium tax credits reduce your monthly insurance premium. The amount of your credit depends on your income as a percentage of the FPL and the cost of the benchmark Silver plan in your area. Here is how the contribution percentages work for 2026:
| Income as % of FPL | Maximum You Pay Toward Benchmark Silver Plan |
|---|---|
| 100% to 150% | 2.0% to 4.0% of income |
| 150% to 200% | 4.0% to 6.3% of income |
| 200% to 250% | 6.3% to 8.2% of income |
| 250% to 300% | 8.2% to 9.7% of income |
| 300% to 400% | 9.7% to 9.8% of income |
| Above 400% | No subsidy available |
For example, if you are a single person earning $30,000 per year (approximately 188% FPL), your expected contribution would be roughly 5.5% of your income, or about $138 per month. If the benchmark Silver plan in your area costs more than that, the federal government covers the difference.
You can apply your tax credit in advance each month to lower your premium, or claim it as a lump sum when you file your tax return.
Cost-Sharing Reductions for Lower Incomes
If your income falls between 100% and 250% of the FPL, you may also qualify for cost-sharing reductions (CSRs). These lower your out-of-pocket costs like deductibles, copays, and coinsurance when you enroll in a Silver-tier plan. CSRs are only available with Silver plans purchased through Your Health Idaho.
The lower your income, the more generous the cost-sharing reductions:
- 100% to 150% FPL: Highest level of cost-sharing reductions (plans similar to Platinum coverage)
- 150% to 200% FPL: Moderate cost-sharing reductions
- 200% to 250% FPL: Modest cost-sharing reductions
CSRs are built into the Silver plan automatically when you qualify. There is no separate application.
Idaho Medicaid vs. ACA Marketplace Coverage
Idaho expanded Medicaid in 2020, which means adults with incomes up to 138% of the FPL can get free or very low-cost health coverage through Idaho Medicaid. If your income falls below the ACA subsidy range, you should apply for Medicaid first.
Key differences:
- Medicaid: No monthly premium for most enrollees. Very low or no copays. Income must be below 138% FPL.
- ACA Marketplace: Monthly premiums apply (reduced by tax credits). Copays, deductibles, and coinsurance vary by plan. Income must be between 138% and 400% FPL for subsidies.
If you are unsure whether you qualify for Medicaid or marketplace coverage, use our free screening tool to find out which programs fit your situation.
How to Apply for ACA Coverage in Idaho: Step by Step
Step 1: Gather Your Information
Before you start, have the following ready:
- Social Security numbers for everyone in your household
- Immigration documents (if applicable)
- Employer and income information (pay stubs, W-2s, tax returns)
- Information about any employer-sponsored coverage available to you
- Policy numbers for any current health insurance
Step 2: Create an Account on Your Health Idaho
Visit yourhealthidaho.org and create an account. You will need a valid email address and will set up a username and password.
Step 3: Complete the Application
Fill out the online application with your household and income details. The system will determine whether you qualify for premium tax credits, cost-sharing reductions, or Medicaid.
Step 4: Compare Plans
Once your eligibility is determined, you can browse available plans. Compare premiums, deductibles, provider networks, and prescription drug coverage. Plans are organized into four tiers:
- Bronze: Lowest premiums, highest out-of-pocket costs
- Silver: Moderate premiums and costs (required for cost-sharing reductions)
- Gold: Higher premiums, lower out-of-pocket costs
- Platinum: Highest premiums, lowest out-of-pocket costs
Step 5: Enroll and Pay Your First Premium
Select a plan and confirm your enrollment. Pay your first monthly premium by the due date to activate your coverage.
Step 6: Get Free Help if You Need It
Your Health Idaho offers free assistance from certified agents, brokers, and Consumer Connectors. You can schedule an in-person or virtual appointment at no cost. Call 855-944-3246 to find help in your area.
Open Enrollment and Special Enrollment Periods
Open Enrollment
The annual open enrollment period for 2026 plans ran from November 1, 2025 through December 15, 2025 in Idaho. If you missed open enrollment, you typically cannot sign up until the next open enrollment period for 2027 coverage.
Special Enrollment Periods
You may qualify to enroll outside of open enrollment if you experience a qualifying life event, such as:
- Losing existing health coverage (including Medicaid)
- Getting married or divorced
- Having or adopting a child
- Moving to a new area in Idaho
- Turning 26 and aging off a parent's plan
- Changes in household income that affect eligibility
Special enrollment periods generally last 60 days from the qualifying event. Apply through Your Health Idaho as soon as possible after your life event.
What Changed for 2026: The End of Enhanced Subsidies
The enhanced ACA subsidies introduced by the American Rescue Plan Act in 2021 and extended by the Inflation Reduction Act through 2025 have expired. Here is what that means for Idaho residents:
Higher premiums for most subsidized enrollees. The enhanced credits reduced premium contributions to a range of 0% to 8.5% of income. The original ACA formula requires contributions of 2% to 9.8% of income, so most people are paying more.
The 400% FPL cap is back. During 2021 through 2025, households earning above 400% FPL could still receive subsidies. That is no longer the case. If you earn above 400% FPL in 2026, you pay full price.
Some people may lose coverage entirely. KFF estimated that nationally, approximately 4 million people could drop coverage due to higher costs. If you are struggling with affordability, check whether you qualify for other programs through our free benefits screener.
Other Programs That May Help
If you do not qualify for ACA subsidies or need additional support, Idaho offers several other assistance programs:
- Idaho Medicaid: Free coverage for incomes below 138% FPL. Apply through the Idaho Department of Health and Welfare or call 1-877-456-1233.
- CHIP (Children's Health Insurance Program): Coverage for children under 19 in families earning too much for Medicaid but below CHIP limits.
- SNAP (Food Stamps): Help with grocery costs for low-income households.
- LIHEAP: Assistance with heating and utility bills.
- EITC (Earned Income Tax Credit): Tax credit for working individuals and families with moderate incomes.
Visit our Idaho Benefits Overview page for a full list of programs available in your state, or run a free eligibility check to see everything you might qualify for.
Frequently Asked Questions
What income do I need to qualify for ACA subsidies in Idaho in 2026?
Your household income must fall between 138% and 400% of the Federal Poverty Level. For a single person, that means earning between approximately $22,025 and $63,840 per year. For a family of four, the range is approximately $45,540 to $132,000. If your income is below 138% FPL, you likely qualify for Idaho Medicaid instead.
Can I still buy a plan on Your Health Idaho if I earn too much for subsidies?
Yes. Anyone who meets the basic eligibility requirements can purchase a marketplace plan regardless of income. You simply will not receive premium tax credits to lower your costs if your income exceeds 400% FPL.
What is Modified Adjusted Gross Income (MAGI)?
MAGI is the income measure used to determine ACA eligibility. For most people, it is very similar to adjusted gross income (AGI) from your tax return, plus any tax-exempt interest, non-taxable Social Security benefits, and foreign earned income.
I missed open enrollment. Can I still get coverage?
Only if you have a qualifying life event, such as losing other coverage, getting married, having a baby, or moving. If you qualify, you have 60 days from the event to enroll through Your Health Idaho.
Did Idaho expand Medicaid?
Yes. Idaho expanded Medicaid effective January 1, 2020. Adults aged 19 to 64 with incomes up to 138% of the FPL can qualify for Medicaid coverage. Apply through the Idaho Department of Health and Welfare at healthandwelfare.idaho.gov or call 1-877-456-1233.
How do I find out if I qualify for Medicaid or a marketplace plan?
The easiest way is to use our free benefits screening tool, which checks your eligibility for ACA coverage, Medicaid, and over 10 other federal and state programs in just a few minutes. You can also apply directly through Your Health Idaho, and the system will determine whether you qualify for Medicaid or marketplace subsidies.
Are dental plans available on Your Health Idaho?
Yes. Your Health Idaho offers 21 stand-alone dental plans in addition to medical coverage. You can browse and enroll in dental plans during the same enrollment period.
Where can I get free help enrolling?
Your Health Idaho provides free enrollment assistance through certified agents, brokers, and Consumer Connectors. Call 855-944-3246 to schedule an appointment or visit yourhealthidaho.org to find local help.
