South Carolina residents shopping for health insurance through the ACA marketplace in 2026 are facing a very different landscape than the past four years. The enhanced federal subsidies that ran from 2021 through 2025 under the American Rescue Plan and Inflation Reduction Act have expired, and the subsidy cliff has returned. That means income limits matter again in a major way: your household income relative to the federal poverty level (FPL) now determines whether you get help paying your premiums and exactly how much.
About 587,567 South Carolinians enrolled in marketplace plans for 2026, a 7% drop from the record 631,948 who enrolled in 2025. The decline tracks directly with the subsidy changes. Even so, 89% of enrollees still qualified for premium tax credits, with average monthly savings of $579 per person.
This guide covers every income threshold you need to know, explains the coverage gap situation in South Carolina, and walks through how to apply.
How ACA Subsidies Work in 2026
The ACA offers two types of financial help for people buying marketplace plans:
Premium tax credits (PTCs) reduce your monthly premium. In 2026, these are available to households earning between 100% and 400% of the FPL. Below 100% FPL, you are expected to qualify for Medicaid. Above 400% FPL, you pay the full unsubsidized premium.
Cost-sharing reductions (CSRs) lower your deductibles, copays, and out-of-pocket maximum. These apply only to Silver-tier plans and only to households earning up to 250% FPL.
Because South Carolina has not expanded Medicaid, households earning below 100% FPL who do not otherwise qualify for Medicaid fall into a coverage gap and are not eligible for either Medicaid or marketplace subsidies. More on that below.
South Carolina ACA Income Limits by Household Size (2026)
ACA subsidy eligibility for 2026 plans is based on the 2025 federal poverty guidelines. The table below shows the income ranges where you qualify for premium tax credits.
100% FPL: Minimum Income for Marketplace Subsidies
| Household Size | Annual Income | Monthly Income |
|---|
| 1 | $15,060 | $1,255 |
| 2 | $20,440 | $1,703 |
| 3 | $25,820 | $2,152 |
| 4 | $31,200 | $2,600 |
| 5 | $36,580 | $3,048 |
| 6 | $41,960 | $3,497 |
400% FPL: Maximum Income for Marketplace Subsidies
| Household Size | Annual Income | Monthly Income |
|---|
| 1 | $62,600 | $5,217 |
| 2 | $84,600 | $7,050 |
| 3 | $106,600 | $8,883 |
| 4 | $128,600 | $10,717 |
| 5 | $150,600 | $12,550 |
| 6 | $172,600 | $14,383 |
If your income falls above 400% FPL, you can still purchase a marketplace plan, but you will pay the full unsubsidized premium with no tax credit.
250% FPL: Cost-Sharing Reduction Cutoff
Households earning at or below 250% FPL are eligible for cost-sharing reductions on Silver plans. These can significantly reduce your annual out-of-pocket costs.
| Household Size | 250% FPL Annual |
|---|
| 1 | $39,150 |
| 2 | $53,100 |
| 3 | $67,050 |
| 4 | $81,000 |
| 5 | $94,950 |
| 6 | $108,900 |
To receive cost-sharing reductions, you must actively select a Silver plan when enrolling. Choosing a Gold or Bronze plan at this income level means you forfeit the CSR benefit even if you are eligible.
Full Income Band Table
The table below shows the full range of FPL percentages and what they mean for your coverage options in South Carolina.
| Income Level | % of FPL | What You Qualify For |
|---|
| Below $15,060 (1 person) | Under 100% | Medicaid if you qualify by category; coverage gap if not |
| $15,060 to $39,150 (1 person) | 100% to 250% | Premium tax credits + cost-sharing reductions on Silver plans |
| $39,151 to $62,600 (1 person) | 251% to 400% | Premium tax credits only (no cost-sharing reductions) |
| Above $62,600 (1 person) | Over 400% | No subsidies; full-price marketplace plan available |
South Carolina's Coverage Gap
South Carolina is one of ten states that have not expanded Medicaid under the ACA. This creates a coverage gap for adults between roughly 0% and 100% FPL who do not fit a Medicaid eligibility category such as pregnant women, children, or people with qualifying disabilities.
Adults in the coverage gap earn too little for marketplace subsidies (which start at 100% FPL) but too much for South Carolina's Healthy Connections Medicaid program. An estimated 65,000 South Carolinians fell into this gap in 2026.
If you are in this group, options are limited. You may qualify for community health center services on a sliding-fee scale, or short-term coverage, though short-term plans do not meet ACA minimum coverage standards and have significant limitations.
You can check your eligibility for any available programs, including Healthy Connections, by using the free benefits screener at BenefitsUSA.
What Changed in 2026: The Subsidy Cliff Returns
From 2021 through 2025, the subsidy cliff at 400% FPL did not exist. The American Rescue Plan (2021) and the Inflation Reduction Act (2022) eliminated the cap temporarily, allowing households at any income level to receive subsidies if their benchmark plan premium exceeded 8.5% of their income.
Congress did not renew those provisions for 2026. As a result:
- Households above 400% FPL no longer receive any premium tax credit
- The "subsidy cliff" is back, meaning a small income increase past 400% FPL can cost thousands in additional annual premiums
- Average unsubsidized premiums in South Carolina rose about 21% for 2026
If you were enrolled in a subsidized plan in 2025 and your income is above 400% FPL, your 2026 premiums increased substantially unless you took action during open enrollment.
Who Offers Marketplace Plans in South Carolina
Six insurers offer plans through HealthCare.gov in South Carolina for 2026:
- Blue Cross Blue Shield of South Carolina
- Ambetter/Absolute Total Care
- Molina Healthcare
- Select Health of South Carolina
- UnitedHealthcare
- InStil Health
Plan availability varies by county. You can compare all options for your ZIP code at HealthCare.gov.
How to Apply for ACA Coverage in South Carolina
South Carolina uses the federally-facilitated marketplace. There is no separate state exchange. All applications go through HealthCare.gov.
Step 1: Check your enrollment window.
Open enrollment for 2026 coverage ran November 1 through January 15, 2026. If you missed it, you need a qualifying life event to trigger a Special Enrollment Period (SEP).
Step 2: Gather your documents.
You will need:
- Social Security numbers for everyone applying
- Employer and income information (pay stubs, tax returns, or self-employment records)
- Policy numbers for any current health coverage
- Immigration documents if applicable
Step 3: Create or log into your HealthCare.gov account.
Visit healthcare.gov and create an account or sign in. Complete the application with household size, income, and residency details.
Step 4: Compare plans.
Review Bronze, Silver, Gold, and Platinum tiers. If your income is at or below 250% FPL, focus on Silver plans to access cost-sharing reductions. If subsidies make a Gold plan cost comparable to Silver, the Gold plan may offer better overall value.
Step 5: Enroll and confirm.
Select your plan, confirm enrollment, and pay your first premium to activate coverage. Keep your summary of benefits and insurance card once they arrive.
Step 6: Report income changes.
If your income changes during the year, update your marketplace application promptly. Underestimating your income can lead to a tax bill when you file; overestimating means you may have paid more out of pocket than necessary.
Need help?
Call the HealthCare.gov helpline at 1-800-318-2596 (TTY: 1-855-889-4325), available 24/7 except federal holidays. You can also find local enrollment assistance through certified navigators and application assisters at localhelp.healthcare.gov.
Special Enrollment Periods
Outside of open enrollment, you can sign up for a marketplace plan if you experience a qualifying life event. Common qualifying events in South Carolina include:
- Losing job-based health coverage
- Getting married or divorced
- Having or adopting a child
- Moving to a new address
- Losing Medicaid or CHIP coverage
- Turning 26 and aging off a parent's plan
You typically have 60 days from the qualifying event to enroll. Visit healthcare.gov or call the helpline to open a SEP application.
Use the Free Screener to Check Your Eligibility
If you are unsure whether you qualify for ACA subsidies, Medicaid through Healthy Connections, or other assistance programs, use the free screening tool at BenefitsUSA. The screener checks eligibility for 11 programs at once and takes about 5 minutes.
Check your eligibility now at BenefitsUSA.org/screener
For a full overview of South Carolina benefits programs, visit the South Carolina benefits guide.
Frequently Asked Questions
What is the income limit for ACA subsidies in South Carolina in 2026?
For 2026, premium tax credits are available to households earning between 100% and 400% of the federal poverty level. For a single person, that range is roughly $15,060 to $62,600 per year. For a family of four, the range is approximately $31,200 to $128,600. These figures are based on 2025 poverty guidelines, which are used for 2026 plan year eligibility.
Did the enhanced ACA subsidies end in 2026?
Yes. The enhanced subsidies introduced by the American Rescue Plan in 2021 and extended by the Inflation Reduction Act through 2025 expired at the end of 2025. Congress did not renew them. As a result, the 400% FPL subsidy ceiling is back, and households above that threshold pay full unsubsidized premiums.
What if my income is below 100% FPL in South Carolina?
South Carolina has not expanded Medicaid, so adults with income below 100% FPL who do not qualify for Medicaid by another category (pregnancy, disability, children) fall into the coverage gap. They are not eligible for marketplace subsidies and do not qualify for Healthy Connections. This affects an estimated 65,000 residents.
How do I qualify for cost-sharing reductions in South Carolina?
You qualify for cost-sharing reductions if your household income is at or below 250% FPL and you select a Silver plan during enrollment. You must actively choose a Silver plan. If you select Bronze or Gold, the CSR benefit does not apply even if your income qualifies.
When is the next open enrollment period for South Carolina ACA plans?
The next open enrollment period for coverage starting January 1, 2027 begins November 1, 2026. It runs through December 15, 2026 in most states. South Carolina uses HealthCare.gov, so enrollment for 2027 plans will be available at healthcare.gov starting November 1, 2026.
Can I still enroll if I missed open enrollment?
You can enroll outside of open enrollment if you qualify for a Special Enrollment Period. Qualifying events include losing job-based coverage, getting married, having a child, moving, or losing Medicaid coverage. You generally have 60 days from the qualifying event to enroll.
Where do I apply for ACA coverage in South Carolina?
South Carolina does not have a state-run marketplace. All applications go through HealthCare.gov. You can apply online at healthcare.gov, by phone at 1-800-318-2596, or with the help of a certified local assister through localhelp.healthcare.gov.
How much will my premium be after subsidies?
That depends on your income, household size, age, and the plan you choose. In 2026, South Carolinians who received subsidies paid an average of about $76 per month after an average subsidy of $579 per month. Your actual amount will vary. Use the HealthCare.gov plan preview tool or a subsidy calculator to estimate your costs before enrolling.
