A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Do I have to repay excess premium tax credits?
If you received advance premium tax credits (APTC) for health insurance you purchased last year, and your income ended up increasing, you might have to pay back some of your APTC. Learn how to determine whether you will have to repay excess APTC when you file taxes.

I was laid off and don’t have any income. What are my health insurance coverage options?

I was laid off, and now do not have any income or insurance. What are my health insurance coverage options?

Depending on where you live, you're likely eligible for Medicaid during the time that you're without an income (but as described below, Medicaid expansion will have a work requirement starting in 2027, which means it will no longer be available to unemployed people). And if you want to purchase a private health plan, losing your employer-sponsored insurance because you were laid off counts as a qualifying event, which gives you a special enrollment period that continues for 60 days from the date your old policy ended (even if you have the option to elect COBRA).

If you get coverage on your own – either Medicaid or a private plan – and then get a new job that provides health insurance benefits, you’ll be able to cancel the interim insurance and switch to your new employer’s plan once you’re eligible for coverage. Coverage in the individual market is issued on a month-to-month basis; there are no annual contracts, so you can cancel at any time, although the only available termination date is typically the last day of the month.

But as we'll discuss in a moment, you should understand the rules related to income-based Medicaid and Marketplace subsidies, to understand whether you're eligible for financial assistance with your coverage.

Since I was laid off, is Medicaid an option for me?

Medicaid may be an option for you, depending on where you live. If you’re in DC or one of the 40 states that have expanded Medicaid as of 2026, coverage is available if your household income is up to 138% of the federal poverty level (FPL). Above that level, Marketplace premium subsidies are available as long as your total household income for the year isn't more than 400% of FPL.

If your state has not expanded Medicaid, eligibility is significantly more restricted, and Medicaid is generally not available to adults in those states who are non-disabled, under age 65, and not a parent/caretaker of a minor child. 1 (Here are Medicaid eligibility guidelines for each state.) Contact your state Medicaid office or the Marketplace in your state to see if you could qualify for Medicaid until you get another job.

Assuming you're in a state that has expanded Medicaid, you'll qualify for Medicaid while you have no income. You can then switch to a private plan in the Marketplace (with subsidies if you're eligible) or to an employer-sponsored plan if you get a job later in the year and your total annual income is going to end up being more than 138% of FPL. You'll have the opportunity to make that coverage change if and when your income picks up again.

A note about impending changes: Starting in 2027 — or earlier or later in some states — there will be a work requirement for Medicaid expansion eligibility. This means coverage will generally not be available while a person is unemployed. But until a work requirement is implemented, Medicaid expansion coverage is available to people with zero income who are currently unemployed, as long as their immigration status makes them eligible for Medicaid.

Although Marketplace subsidy eligibility is always based on total annual household income (an ACA-specific calculation of MAGI), Medicaid eligibility can be based on current monthly income.2 So even if your total income for the year will end up being above the Medicaid eligibility level — due to income you earned earlier in the year or income you might earn later in the year — you can qualify for Medicaid in most states if your current monthly household income doesn't exceed 138% FPL.

If your total household income for the year — including income you earned earlier in the year and any income you expect to earn later in the year — will end up being above 138% FPL (or above the poverty level in a state that hasn't expanded Medicaid), you could instead enroll in a Marketplace plan, with a premium subsidy if your income makes you eligible.

If you’re in the coverage gap because you’re in a state that hasn’t expanded Medicaid and your projected household income for this year is below the poverty level, you’ll have an opportunity to enroll in a subsidized health insurance plan through the Marketplace later in the year if you find a job that puts your income at or above the poverty level (assuming the job doesn’t come with health insurance and you need to purchase your own coverage).

Is short-term health insurance a good option if you've been laid off?

If you’re unable to afford an ACA-qualified plan while you’re between jobs, and you're not in a state where Medicaid is available, you might find yourself considering a short-term health insurance plan.

These temporary health insurance plans are not regulated by the ACA, so they still use medical underwriting, don’t cover pre-existing conditions, impose caps on benefits, don't have to cover preventive care, etc. But they're better than nothing and they're less expensive than an ACA-qualified plan for people who aren't subsidy-eligible (which includes many adults with household income below the federal poverty level in a state that hasn't expanded Medicaid).

But between Medicaid expansion in most states, Marketplace subsidies, and the fact that loss of an employer-sponsored health plan will trigger a Marketplace special enrollment period, very few people have to turn to short-term health insurance.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.

Footnotes

  1. "Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level" KFF.org. Accessed Jan. 29, 2026 
  2. "Income Definitions for Marketplace and Medicaid Coverage" Center on Budget and Policy Priorities. Updated Aug. 2025 

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