Free calculator
Family glitch calculator
Since 2023 the affordability test looks at what it costs to cover the whole family, not just the employee. If that is more than 9.96% of household income, a spouse and children may qualify for Marketplace help even when the employee's own coverage is cheap.
- Post-2022 rule
- Tests both figures
- Shows the ceiling in dollars
Run the numbers
Is the family offer affordable, or is it not?
Your affordability test
The family may qualify for Marketplace help
Family cover costs 11.50% of household income, above the 9.96% line. Since 2023 the family is tested on the family premium, not the employee-only one, so a spouse and children can take premium tax credits even though the employee's own cover is affordable.
- Household income for the year
- $72,000
- Affordability ceiling
- $7,171 a year ($598 a month)
- Employee-only cost
- $1,620 a year — 2.25% of income
- Employee-only verdict
- Affordable — no subsidy for the employee
- Family cost
- $8,280 a year — 11.50% of income
- Family verdict
- Unaffordable — the family may qualify
- Amount over the ceiling
- $1,109
Anyone who moves to the Marketplace leaves the job plan. Compare the whole household's premiums, deductibles and doctors before you split the family across two plans.
The rule
Two tests, run separately, on the same household
The employer's offer is measured against a single percentage of household income. It is run twice — once on the employee-only premium and once on the family premium — and the two answers can, and often do, disagree.
Affordable if annual premium share ÷ household income ≤ 9.96%
When the employee-only figure passes but the family figure fails, the household splits: the employee stays on the job plan and the spouse and children can take premium tax credits on the Marketplace. Before doing that, compare the two plans' deductibles and doctors — a subsidised premium is not automatically the cheaper year.
| Household income | Affordable up to, a year | Affordable up to, a month |
|---|---|---|
| $40,000 | $3,984 | $332 |
| $55,000 | $5,478 | $457 |
| $72,000 | $7,171 | $598 |
| $90,000 | $8,964 | $747 |
| $120,000 | $11,952 | $996 |
| $150,000 | $14,940 | $1,245 |
The rewritten rule
What people ask about the family glitch
Until 2023 the affordability test looked only at the cost of covering the employee alone. A family could be offered coverage costing a third of household income and still be barred from subsidies, because the employee-only figure was cheap. The rule was rewritten so the family is now tested on the family premium.
The employee's own share after the employer contribution — the amount that comes out of the pay packet, not the total cost of the plan. Both boxes want that same deduction: one for employee-only cover, one for the family tier.
Only if the employee-only figure also fails the test. The two verdicts are separate on purpose, which is why a household often ends up split — the employee stays on the job plan and the family takes a subsidised Marketplace plan.
Yes. It must also provide minimum value, broadly meaning it pays at least 60% of expected costs. An offer that is affordable but fails minimum value does not block subsidies either.
Your best estimate of household modified adjusted gross income for the coverage year — not last year's. The Marketplace reconciles the estimate against the actual figure at tax time, so a careful guess now avoids a bill later.
2026 plan year
The figures this calculator uses
Sample figures for the 2026 plan year. Medicare and the Marketplace reset these every autumn.
- Affordability percentage (2026 sample)
- 9.96% of household income
- Employee-only test
- Decides whether the employee can be subsidised
- Family test
- Decides whether a spouse and children can be
- Rule in force since
- Plan years beginning 2023
Every figure above is a sample for the 2026 plan year on a demonstration site. Medicare publishes the real ones each autumn at Medicare.gov, and they change every year.