ACA Marketplace

Usually not. Starting by January 1, 2027, adults 19 to 64 covered through Medicaid expansion must show 80 hours a month of work, community service, a work program, or half-time school, unless they qualify for an exemption. If you are denied or dropped from Medicaid only because you didn't meet that requirement, you also can't get a premium tax credit for a marketplace plan. If you lose Medicaid for another reason, such as higher income, you can usually get a subsidy through a 60-day special enrollment period.

Starting with 2027 coverage, only three groups of immigrants can get premium tax credits and cost-sharing reductions: green card holders (lawful permanent residents), Cuban and Haitian entrants, and people living in the U.S. under the Compacts of Free Association (from Micronesia, the Marshall Islands, or Palau). Other lawfully present immigrants, including refugees, asylees, people with Temporary Protected Status, and people on work or student visas, can still buy a marketplace plan but have to pay the full price. Green card holders do not face a five-year wait for marketplace subsidies; that wait applies to Medicaid.