Marketplace vs. Private Health Insurance

Why this changed in 2026

The temporarily enhanced Marketplace subsidies that expanded eligibility to nearly everyone expired at the end of 2025. As of 2026, the standard rule is back: households above 400% of the federal poverty level no longer qualify for a subsidy at all. That income cap now rules out a large share of people who may have qualified for help in the past few years — which means private plans are worth a serious look for far more people than before.

Private plans

Private plans are sold directly through carriers, outside the Marketplace. Without the constraint of Marketplace-only pricing and metal-tier rules, private plans often offer more plan variety and more competitive pricing — especially for anyone who doesn’t qualify for a subsidy, which under the current income cap is most people above that 400% threshold. Eli specializes in comparing private plans across multiple carriers to find the one that actually fits your situation.

Marketplace plans

ACA Marketplace plans are the only place to access a subsidy. If your household income is clearly under the 400% FPL threshold, a Marketplace subsidy can make a real difference in your monthly cost.

How to actually decide

The starting point is your household income relative to that 400% cutoff. Above it, private plans are usually the stronger option, and that’s exactly where Eli can help — comparing private plans across carriers to find real savings and the right fit. Below that threshold, a subsidy may outweigh what a private plan offers — Eli can help you weigh that too.

Think private coverage might be the right fit for you? Get a free quote and Eli will compare private plan options across carriers for your situation.