Who can get this

Most people who do not have health insurance through a job can sign up. Here is the short version.

You live in one of those twelve states.

You are a U.S. citizen, or you are lawfully present in the country.

You are not on Medicare.

Your job does not offer coverage you can afford.

That last one has a specific meaning. If your job offers a plan, it only blocks you if the plan is considered affordable — and in 2027 "affordable" means it costs you less than 10.22% of your household income. That is a high bar. A lot of people assume their job disqualifies them when it does not.

There is also a rule worth knowing if you have a family. If your job's plan is cheap for you alone but expensive to add your spouse and kids, your family may still qualify for help even though you do not.

This is the rule that surprises people most, and it works the opposite way from what you would expect.

In some states, if you earn too little, you get nothing.

Six of the states we work in did not expand Medicaid: Florida, Georgia, Mississippi, South Carolina, Tennessee and Texas. In those six, Medicaid for adults stops at a very low income — in several of them an adult with no children does not qualify at any income at all. And the help for Obamacare does not start until you reach the poverty line, which is $15,960 a year for one person in 2027.

So an adult in one of those six states earning $11,000 a year can fall in a hole. Too much for Medicaid. Too little for help with Obamacare. Hundreds of thousands of people are in that hole right now.

Three things worth knowing if this might be you:

Count everything. Side work, cash work, seasonal work, a spouse's income, money you expect to earn later this year. People land in the hole on paper who are not actually in it, because they only counted one paycheck.

Your children may still qualify even if you do not. Every one of these states covers kids at a much higher income than adults, and pregnant women at a higher income still. That is a different application and it is worth doing. Ask us.

And if you live in Arizona, Michigan, North Carolina, Ohio, Utah or Wisconsin, this hole does not exist. Those states cover adults up to at least the poverty line. If your income is low there, the answer is probably Medicaid, which will cost you less than anything we could sell you. We will tell you that rather than sell you something.