Health coverage · United States
Health Insurance
Health insurance in the US pays a share of your medical costs in exchange for a monthly premium. If no employer covers you — self-employed, freelancing, between jobs, on a visa, or running a small business — you buy your own through the ACA Marketplace, a state exchange, COBRA, or a short-term plan. This section covers those routes.
Enrollment, subsidy and deduction rules come from HealthCare.gov, CMS, the IRS and KFF, and are dated because they change. Exchange details for each state come from our state registry.
Last reviewed August 1, 2026
In this section
- Self-employed health insurance
- Health insurance by state
- Short-term health insurance
- Small business health insurance
- Open Enrollment 2027
- Subsidy calculator
- Missed Open Enrollment?
Start here
Coverage routes for people without an employer plan.
Self-employed health insurance
Wave 3Freelancers, contractors and 1099 earners: pricing a Marketplace plan, estimating variable income, claiming the premium deduction. Plus guides for realtors, consultants, rideshare drivers and owner-operators.
Read the guideHealth insurance by state
Texas, California, Florida, Washington, Illinois, Georgia and Pennsylvania — where you enroll, what plans cost locally, and which deadline applies.
Read the guideShort-term health insurance
STLDI plans explained honestly: the current federal duration rules and their enforcement status, what these plans exclude, and which states restrict them.
Read the guideSmall business health insurance
Covering employees: group plans, SHOP eligibility, and when a small employer is better off not offering coverage at all.
Read the guideOpen Enrollment 2027
The dates for plan year 2027, how they differ between HealthCare.gov and state exchanges, and what to do before the window closes.
Read the guideSubsidy calculator
Estimate your premium tax credit from household income and size. Estimate only — the Marketplace makes the final determination.
Read the guideMissed Open Enrollment?
Which life events open a 60-day Special Enrollment Period, and what your options are if none of them apply to you.
Read the guideWhere to get coverage when no employer provides it
Four routes cover almost everyone. The ACA Marketplace — HealthCare.gov federally, or your state's own exchange — is the main one, and the only place premium tax credits exist. COBRA continues an old employer plan at full cost. Short-term plans are cheaper and cover far less. Joining a spouse's or parent's plan is often overlooked.
Below an income threshold the answer is Medicaid, not a paid plan, and Medicaid accepts applications year-round rather than only during Open Enrollment.
Sources: HealthCare.gov · HealthCare.gov — unemployed
What changed for 2026 and 2027
The temporary enhanced premium tax credits expired on January 1, 2026, restoring the 400%-of-federal-poverty-level subsidy cliff. KFF puts the average monthly net premium after tax credits at $178 for 2026 against $113 for 2025, and the share of enrollees receiving any credit down from 92% to 87%. The underlying premium tax credit itself did not expire — only the temporary expansion did.
Enrollment windows are also in flux, and federal-platform and state-exchange dates no longer match. We keep dates on the Open Enrollment page rather than here, so there is one place to check rather than two. Verified August 1, 2026.
Sources: Congressional Research Service · KFF · CMS
Your state decides where you enroll
Some states run their own exchange; the rest use the federal platform. Of the seven we cover, Texas and Florida enroll through HealthCare.gov, while California uses Covered California, Washington uses Washington Healthplanfinder, Illinois uses Get Covered Illinois, Georgia uses Georgia Access, and Pennsylvania uses Pennie.
The distinction is practical, not cosmetic: state exchanges set their own deadlines within federal limits, and some add state-level subsidies on top of the federal credit.
Source: CMS
FAQ
Common questions
Short answers here, sourced pages in the Answers Library.
Browse the Answers LibraryCan I get health insurance if I don't have a job?
Yes. Losing job-based coverage is a qualifying life event, so you can enroll through the Marketplace outside Open Enrollment. You have 60 days from the date coverage ends. Depending on household income you may also qualify for Medicaid or for premium tax credits.
Source: HealthCare.gov
Who is eligible to use the Health Insurance Marketplace?
You must live in the United States, be a US citizen or national or a lawfully present non-citizen, and not be incarcerated. People enrolled in Medicare cannot buy a Marketplace plan. Eligibility to use the Marketplace is separate from eligibility for savings.
Source: HealthCare.gov
Is there an income limit for a Marketplace subsidy in 2026?
Yes, again. The temporary enhanced premium tax credits expired on January 1, 2026, restoring the 400%-of-federal-poverty-level cutoff. Above that line you pay full price. The underlying premium tax credit itself did not expire — only the temporary expansion did.
Source: Congressional Research Service
What if I missed Open Enrollment?
You generally wait for the next Open Enrollment unless you have a qualifying life event — losing coverage, moving, marriage, or a new child. Those open a Special Enrollment Period, usually 60 days. Medicaid and CHIP accept applications year-round.
Source: HealthCare.gov
Can I deduct health insurance premiums if I'm self-employed?
Often yes. The self-employed health insurance deduction is claimed on Schedule 1 (Form 1040), line 17, computed on Form 7206. It cannot exceed earned income from the business the plan is established under, and is unavailable for any month you were eligible for an employer-subsidised plan — including a spouse's.
Source: IRS — Form 7206 instructions
What are Bronze, Silver, Gold and Platinum plans?
They are the four Marketplace metal categories, set by how you and the plan split costs — not by quality of care. Bronze has the lowest premium and the highest out-of-pocket costs; Platinum the reverse. Cost-sharing reductions are only available on Silver plans.
Source: HealthCare.gov
No employer plan is a situation, not a problem.
Whether you file a 1099, run a small crew, or are simply between jobs, the route to coverage differs. Start with the one that matches how you earn.
- Independent — we don't sell insurance
- No forms, no sales calls
- Sourced from NAIC & state DOIs