ACA Marketplace, short-term, COBRA, or Medicaid — how to choose
For 2026, 91% of HealthCare.gov enrollees qualify for a premium tax credit thanks to the extended ARPA/IRA subsidy enhancements (Congressional Budget Office, 2025). A family of four earning $80,000 in a benchmark Silver plan typically pays $0–$200/month after subsidy versus a $1,950/month sticker price. The first move when you lose employer coverage should always be to model the ACA subsidy — not to default to COBRA, which is almost always the most expensive option ($600–$2,400/mo for the full unsubsidized employer rate).
Short-term limited-duration insurance (STLDI) is the right answer in three specific cases: you're between jobs for under 4 months and healthy, you missed Open Enrollment and have no Qualifying Life Event, or you need stop-gap coverage before Medicare kicks in. The catch: STLDI excludes pre-existing conditions, caps annual benefits, and is now banned outright in CA, NY, NJ, CO, and WA — and limited to 3 months in most other states under the 2024 federal rule.
Medicaid (and CHIP for kids) is the right answer if your household earns under 138% of the federal poverty level — $20,783/yr for a single adult, $43,056 for a family of four in 2026. Coverage is functionally free, and 40 states + DC have expanded eligibility. CoverShield's licensed health agents can model your subsidy and Medicaid eligibility in the same 10-minute call.