On October 15, 2026, the IRS and Treasury Department published proposed regulations implementing new Affordable Care Act premium tax credit rules under H.R. 1 (P.L. 119-21). If you buy health insurance through the federal Marketplace on HealthCare.gov, which is the exchange Florida uses, these changes could affect your tax credit eligibility, your enrollment paperwork, and, starting with your next tax return, what you owe if your income estimate was off. As of October 16, 2026, the rules are proposed, not final, but parts of the underlying law are already in effect.
This post explains what is proposed, what is already law, and the practical steps Florida shoppers can take before open enrollment ends on December 15.
What happened this week
The IRS and Treasury issued proposed regulations (REG-101576-26, published in the Federal Register at 91 FR 65494 on October 15, 2026) implementing Section 36B premium tax credit changes enacted by H.R. 1, commonly called the One Big Beautiful Bill Act. The proposal:
- Conforms regulations to the repeal of limits on repayment of excess advance premium tax credits (APTCs).
- Adds new exchange verification requirements before advance credits are paid.
- Narrows which lawfully present immigrants can be counted in the credit calculation.
- Addresses how Medicaid work (community engagement) requirements interact with credit eligibility.
- Updates marketplace reporting rules, including Form 1095-A.
The public comment period runs through November 30, and a public hearing is scheduled for December 8. Nothing in this post is tax or legal advice; for how the rules apply to your return, talk with a tax professional.
The change already in effect: repayment caps are gone for tax year 2026
This is the provision with the most direct impact on tax returns. Under the old rules, if the Marketplace paid more advance credit on your behalf than your actual income supported, income-based caps limited how much you had to repay, protecting many taxpayers under 400% of the federal poverty level.
H.R. 1 repealed that repayment limitation for tax years beginning after December 31, 2025. That means for the 2026 tax year, the return you will file in spring 2027, there is no cap. If your actual income comes in higher than you estimated, you repay the entire difference. Treasury and the IRS estimated that about 3.7 million tax returns in 2028 will include repayment of excess APTCs.
A checklist for getting your income estimate right
- Estimate conservatively and completely. Include wages, bonuses, self-employment income, retirement account withdrawals, and a spouse’s income changes, not just your base salary.
- Count the whole household. The credit is based on household income, so a spouse’s second job or a teenager’s summer earnings can matter.
- Update HealthCare.gov when income changes. A raise, a new job, or extra freelance income mid-year changes the credit you qualify for. Reporting changes promptly keeps your advance payments accurate.
- Keep documentation. Pay stubs, 1099s, and records of income changes help you reconcile correctly on Form 8962 with the Form 1095-A the Marketplace sends each January.
- Talk to a tax professional. A bad income estimate used to be a manageable surprise. Now it can mean owing thousands back with your return.
What is proposed for 2027 and later (not final yet)
The following provisions are proposals. They could change before they are finalized, and the Department of Health and Human Services is expected to issue parallel proposed regulations on the exchange procedures.
Stricter verification before advance credits are paid
For tax years beginning after December 31, 2027, a month generally would not qualify as a premium tax credit coverage month unless the exchange verifies required enrollment information. For people receiving advance credits, exchanges would have to verify household income, family size, eligibility for other minimum essential coverage, and, where applicable, eligible-alien status.
Narrower credit calculations for some lawfully present immigrants
Beginning with tax years after December 31, 2026, taxpayers would generally have to exclude premiums attributable to individuals who are lawfully present but are not “eligible aliens” when calculating the credit. Marketplace reporting would change too: exchanges would exclude from reported enrollment and benchmark premiums the amounts allocable to those individuals.
The proposal also removes regulatory language reflecting a prior rule that let certain lawfully present immigrants with household income below 100% of the federal poverty level qualify for the credit when immigration status made them ineligible for Medicaid. H.R. 1 repealed that statutory provision for tax years beginning after December 31, 2025, meaning it is already law for 2026.
Medicaid work requirements and credit eligibility
The proposal addresses H.R. 1’s Medicaid community-engagement provisions. Individuals who would otherwise qualify for Medicaid but fail community-engagement requirements would generally be treated as eligible for Medicaid minimum essential coverage for premium tax credit purposes, making them ineligible for the credit during those months. Community engagement can include working, being enrolled in an educational program, or participating in a work program or community service at least 80 hours a month. The proposal includes examples showing how eligibility changes if a person later becomes ineligible for Medicaid for a different reason, such as higher income.
Treasury and the IRS estimated the regulations could affect about 5.6 million individuals enrolled in exchange coverage, including 13.5 million enrollees potentially eligible to claim the credit.
What Florida shoppers should do before December 15
Open enrollment for 2027 coverage runs November 1 through December 15. With credit rules in flux, a careful enrollment is more valuable than a fast one.
- Start early on HealthCare.gov. Florida uses the federal Marketplace, so these verification and eligibility changes will flow through the same application Florida shoppers already use.
- Enter your best income estimate, then double-check it. With no repayment cap for 2026, the cost of an optimistic estimate lands on your tax return.
- Compare plans beyond the premium. Check that your doctors are in network and your prescriptions are covered before you enroll. See our checklist: Will Your New Health Insurance Cover Your Prescriptions? A Before-You-Enroll Checklist.
- Plan for documentation. Stronger verification means the exchange may ask for more proof of income, household size, or status. Gather pay stubs and household records before you apply.
- Get help from a licensed agent. Plan comparisons, network checks, and enrollment timing are exactly what a Florida-licensed health insurance agent does every day.
- Keep your tax professional in the loop. Credit eligibility and repayment are tax questions. An agent helps you choose the plan; a CPA helps you plan for the return.
Frequently asked questions
Is the October 15 rule final?
No. These are proposed regulations, with comments due November 30 and a hearing on December 8. Some provisions, like the repeal of the repayment cap and the end of the below-100%-poverty exception, reflect statutory changes in H.R. 1 that are already law.
Does this change my 2027 premiums?
Premiums are set by insurers and approved by state regulators. These rules change how tax credits are calculated, verified, and reconciled, which affects what you pay after the credit and what you owe at tax time.
I already have Marketplace coverage. What should I do?
Review your income estimate for 2026 now, while there is still time to adjust your advance payments. When open enrollment begins November 1, re-shop rather than auto-renewing, since plan options, prices, and your credit amount can all change.
Does this affect employer-sponsored coverage?
These rules apply to premium tax credits for Marketplace coverage, not to employer group plans. If you have an offer of affordable employer coverage, you generally do not qualify for Marketplace credits anyway.
How Coverage Babe can help
Coverage Babe is a Florida health insurance agency run by Sean Wigand and Lishele Wigand, Florida-licensed health insurance agents. We help Florida individuals and families compare Marketplace and private plan options, check networks and prescriptions before enrollment, and time applications around open enrollment deadlines.
Book a consultation to review your 2027 options before December 15. Learn more about Coverage Babe.
Compliance note: This post is general information only, not tax, legal, or financial advice, and not medical advice. For individuals shopping the Marketplace. Coverage Babe’s CB Premier Benefits is a supplemental employee-benefits program, not insurance and not a replacement for major medical coverage; plan and program documents control. As of October 16, 2026; rules described are proposed except where noted as enacted law. Florida only; Sean and Lishele Wigand are licensed in Florida and do not advise on coverage in states where they are not licensed.