ACA Subsidies End for H-1B, H-4 and F-1 Households in 2027: How to Plan Your Health Coverage
A statutory cut-off scheduled for 2027 coverage ends marketplace premium tax credits for H-1B, H-4 and F-1 holders, while excess 2026 advance credits are repaid in full.
Part of our guide to the H-4 EAD.
Short answer, as of November 1, 2026: no. H-1B workers, H-4 spouses and F-1 students (including OPT and STEM OPT) cannot get ACA subsidies for 2027 marketplace coverage. Federal law ends the premium tax credit for lawfully present immigrants who are not "eligible aliens," starting with tax years that begin after December 31, 2026, and state exchange summaries place these visas outside the eligible group. The cut-off is scheduled by statute. Treasury's implementing rules are only proposed (91 FR 65494, comments due November 30, 2026). You can still buy a marketplace plan for 2027; you just pay the full premium.
Status line (as of 2026-11-01). Scheduled (statute): a zero premium tax credit for 2027 coverage for lawfully present people outside three groups. In effect for tax year 2026 (statute): no cap on repaying excess advance credits, and no credit for lawfully present people below 100% of the federal poverty line who are barred from Medicaid by their status. Proposed: Treasury and IRS regulations REG-101576-26 (RIN 1545-BS15), published 2026-10-15; comments close 2026-11-30; a telephonic hearing is set for 2026-12-08 at 10 a.m. ET, but it is cancelled if no outline of topics arrives by 11-30 (Treasury publishes a cancellation notice in the Federal Register).
Open enrollment for 2027 plans starts November 1, 2026 in most states, according to KFF, so the decisions below are live this month.
Can H-1B holders get ACA subsidies in 2027?
No. Under a statutory cut-off scheduled for coverage starting January 1, 2027, the only noncitizens who can get the premium tax credit are lawful permanent residents, Cuban and Haitian entrants, and people living in the US under a Compact of Free Association. H-1B, H-4 and F-1 holders, including OPT and STEM OPT, are not among them, so their marketplace plans cost full price.
The change comes from section 71301 of Public Law 119-21 (the One Big Beautiful Bill Act, signed July 4, 2025), which amended section 36B of the Internal Revenue Code. Treasury's October 15 proposal summarizes the effect plainly: the amendment, "effective for taxable years beginning after December 31, 2026, also excludes lawfully present alien family members who are not 'eligible aliens.'"
The proposal itself does not list visa types, which is why you should read the state summaries rather than guess. KFF's marketplace FAQ, updated for plan year 2027, names only the three groups above. Covered California's partner fact sheet is more direct. It says that starting in 2027 "only these immigrant groups will be eligible for financial assistance," and it lists consumers with work visas and student visas among those losing premium tax credits and cost-sharing reductions. H-4 is a dependent status rather than a work or student visa, but it is not one of the three statutory groups, so it loses the credit too. Covered California estimates that approximately 140,000 of its own enrollees may be affected.
Two things do not change. Being lawfully present still lets you buy a plan: Covered California says affected consumers "will still be able to enroll," just without financial assistance. And your 2026 plan is untouched; the same fact sheet says the changes "do not affect current plan costs."
Health insurance subsidy rules for visa holders in 2027, by status
Premium tax credit eligibility by status, as of 2026-11 (2027 cut-off scheduled by statute; regulations proposed)
| Your status, or a family member's | 2026 plan year | 2027 plan year |
|---|---|---|
| H-1B, and other work visas such as L-1, O-1, TN or E-3 | Can qualify if household income is at least 100% of the poverty line and the other tests are met | No credit (not one of the three groups); you can still buy a plan at full price |
| H-4, with or without an H-4 EAD | Same tests as H-1B | No credit; not one of the three eligible groups |
| F-1 student, OPT or STEM OPT | Same tests; a low student income can fall below the 100% floor | No credit; Covered California lists "student visas" |
| Green card approved during 2027 | Not applicable | An eligible group from the approval onward, if otherwise qualified (our reading; confirm with your exchange) |
| Lawful permanent resident | Can qualify | Can qualify |
| US-citizen spouse or child | Can qualify | Can qualify for their own share |
The 100% floor for 2026 applies to every visa row: since tax year 2026, a lawfully present person below 100% of the poverty line who is barred from Medicaid by status gets no credit. An H-4 EAD does not change your status for this purpose; you are still in H-4. For the employer-plan and dependent options an H-4 spouse has, see our guide to health coverage options for an H-4 spouse.
What is scheduled, what is in effect, and what is only proposed
Three OBBBA provisions hit visa households on two different dates, and only the regulations are a proposal.
Old rule, new rule, what to do (as of 2026-11)
| Rule | Before | Now or next | Status | What to do |
|---|---|---|---|---|
| Who can get the credit | Most lawfully present immigrants, including H-1B, H-4 and F-1 | Only the three eligible groups, from tax years beginning after 2026-12-31 | Scheduled (statute) | Price 2027 plans at the full premium |
| Lawfully present, income below 100% of the poverty line, barred from Medicaid by status | Could qualify | Not eligible, from tax years beginning after 2025-12-31 | In effect (statute) | If 2026 income may land below 100%, have a tax professional review before you file |
| Repaying excess advance credits | Capped for incomes under 400% of the poverty line | Repaid in full, from tax years beginning after 2025-12-31 | In effect (statute) | Report income and status changes to your exchange promptly |
| Enhanced credits | Larger credits in recent years | "In 2026, the enhanced premium tax credits expired," per KFF | Expired | Expect smaller 2026 credits than before |
| Treasury regulations (REG-101576-26) | No rules implementing these changes | Published 2026-10-15; comments close 2026-11-30 | Proposed | Comment if you wish; the statute applies regardless |
Comments can shape how Treasury computes the credit and what exchanges report on Form 1095-A. They cannot restore a credit that Congress removed by statute (our reading). If you want to comment, the docket is IRS-2026-1420 on regulations.gov.
What happens to my 2026 premium tax credit at tax time?
You reconcile it on Form 8962, filed with your 2026 federal return, using the Form 1095-A your exchange sends by January 31, 2027. For tax year 2026 the repayment cap is gone, so any advance credit above what you were actually entitled to is added to your tax in full. The 2027 cut-off does not reach back into 2026.
Common misconception: "If my income comes in higher than I estimated, my repayment is capped." Correction: section 71305 of the OBBBA removed the cap for tax years beginning after December 31, 2025. Treasury's proposal says that for those years "the full amount by which APTC exceeds PTC allowed under section 36B increases the taxpayer's tax liability for that taxable year." Some IRS help pages, such as the reconciliation page (last updated 2026-08-09), still describe the old caps, so do not rely on them for 2026. KFF's open-enrollment guide also says the caps are gone from tax year 2026.
Here is how that plays out, with hypothetical figures used only for the arithmetic. Say the exchange paid $250 a month in advance credits from July through December 2026, a total of $1,500. A raise and a bonus in October lifted your 2026 household income above your estimate, and Form 8962 shows you were entitled to $600. Under the pre-2026 rules part of the $900 gap might have been capped, depending on your income. For 2026, the whole $900 is added to your tax.
The second 2026 trap hits low-income households, which can include students. Treasury's proposal says that for tax years after 2025, a lawfully present taxpayer with household income below 100% of the poverty line who is ineligible for Medicaid because of status "is not eligible for the PTC." Advance payments made for such a year could have to be repaid. Separate rules cover people whose income came in below what the exchange estimated, so have a tax professional review the return before you file.
Which return you file matters too. F-1 students in their first years are usually nonresidents who file Form 1040-NR (see Form 1040 or 1040-NR). A 2026 1040-NR is due 2027-04-15 with withheld wages, otherwise 2027-06-15 (our arithmetic; the 2026 instructions are not posted yet). How Form 8962 works with a nonresident return is a question for a tax professional who handles nonresident returns.
What are my options if I lose subsidies between jobs?
Start with an employer plan, yours or your spouse's. Then compare COBRA against a full-price marketplace plan, then a school plan if you are a student, and treat short-term plans as a last resort.
Household decision table (as of 2026-11)
| Household | Check first | Then compare | Watch for |
|---|---|---|---|
| H-1B worker with a job | Your employer plan at 2027 benefits enrollment | Little else; a marketplace plan carries no credit for you either way | Waiting periods if you change employers |
| H-1B worker laid off in 2027 | The COBRA election notice | A full-price marketplace plan in a special enrollment period | The 60-day grace period (proposed for elimination, still in effect) runs at the same time |
| H-4 spouse | The family tier of the H-1B spouse's plan | Your own employer plan if you work on an H-4 EAD; COBRA if the H-1B spouse loses the job | The H-1B spouse's job loss ends your coverage too |
| F-1 student enrolled in school | The school plan or an approved waiver | A full-price marketplace plan | Your school's waiver deadlines |
| F-1 on OPT or STEM OPT between jobs | COBRA from the last employer, or a school plan if graduates may stay on it | A full-price marketplace plan | 90-day (150 with STEM OPT) unemployment limits |
| Mixed-status household (citizen or green card holder plus a visa holder) | An employer plan covering everyone | A marketplace plan, where eligible members keep a credit for their share | Listing each person's status accurately |
COBRA
COBRA lets you keep your former employer's plan for a limited time. The Department of Labor's COBRA page says it generally applies to plans of employers with 20 or more employees, and that you "may be required to pay the entire premium for coverage up to 102% of the cost to the plan." It keeps your doctors and network. Our comparison of COBRA and marketplace coverage during a job gap walks through the election mechanics; for 2027, set COBRA against the marketplace's unsubsidized price.
A full-price marketplace plan
You keep the right to enroll. KFF's FAQ gives "losing other coverage" as an example of a special enrollment trigger; your exchange sets the exact window, so check it the day your coverage end date is confirmed.
Your spouse's employer plan
Losing your own coverage may let your spouse add you to their plan mid-year, but employer plans set short request windows. Ask your spouse's HR team for the deadline in writing.
Student plans
Universities set their own rules on whether OPT graduates may stay on the student plan. Start with our overview of student health insurance requirements and waivers, then ask your school's student health office.
Short-term plans
Read the exclusions before you buy. KFF's October 2025 review notes that these plans can "deny coverage for people with pre-existing conditions, or exclude coverage for those conditions," and that five states then banned their sale outright.
The 2027 timing trap for anyone between jobs
In 2026, the credit could make a marketplace plan the cheap bridge between jobs. In 2027 that option is full price, and the bridge has to fit inside an immigration clock. Here is a worked timeline for a hypothetical H-1B worker whose last day of work is Friday, 2027-03-12.
- On the last day, confirm your coverage end date. Your employer plan may end on your last day or at the end of the month (Wednesday, 2027-03-31). The plan's summary plan description decides which.
- Count the grace period. Under the current rule you have up to 60 days, which here runs through Tuesday, 2027-05-11 (our arithmetic), or until your I-94 ends if that comes sooner. DHS has proposed eliminating that 60-day grace period (91 FR 57807); it is a proposal only, with comments closing 2026-11-10, so check for any final rule on your last day. Our H-1B 60-day grace period guide covers the status options to raise with an attorney.
- Price COBRA against the full-price marketplace plan as soon as the COBRA election notice arrives. Do not assume the marketplace is cheaper, because in 2027 you get no credit.
- Check the new employer's waiting period when you accept an offer. A plan that starts on the first of the following month can leave a gap even after your new H-1B employment begins.
- Watch your exchange notice for any advance credit. If one appears for the gap months, call the exchange before you accept it. Excess credits for 2027 would be repaid in full on the 2027 return you file in 2028, after Form 1095-A arrives by 2028-01-31.
OPT and STEM OPT workers face the same arithmetic against a different clock: the 90-day unemployment limit, or 150 days with STEM OPT, which is unchanged and set out by SEVP. Your DSO can confirm how many unemployment days you have used.
Mixed-status families: how the credit is split
If one spouse is a green card holder or citizen and the other holds H-1B or H-4, the household is not shut out entirely. Section 71301 extends the existing premium carve-out for family members who are not lawfully present to those who are lawfully present but not eligible aliens. The proposed regulation says the taxpayer "must reduce the enrollment premiums ... by the portion of the premiums attributable to such individual," and its worked example has a citizen whose spouse is in exactly that position. In our reading, the credit survives for the eligible members' share, for example a US-citizen child, unless they can get employer coverage the IRS eligibility rules treat as "affordable coverage through an eligible employer-sponsored plan that provides minimum value." The proposal also sets a formula for splitting premiums when more than one family shares a policy. Have a tax professional run your numbers before you rely on a partial credit.
Could a 2026 subsidy affect a future green card?
Possibly, and this is a question for an immigration attorney, not your exchange. Covered California's fact sheet warns that "receiving financial assistance for health insurance may affect" a green card application. The DHS public charge final rule is in effect and challenged in court, with no order blocking it (as of 2026-11-01). USCIS guidance says officers may consider "any and all benefits" received on or after September 18, 2026, with earlier benefits judged under the narrower 2022 test. Its examples (cash assistance, housing assistance, food stamps, college financial aid) do not name marketplace subsidies, and it does not say how a premium tax credit is weighed. Our explainer on what counts as public charge since September 18, 2026 covers the split by date.
How to plan your 2027 coverage, step by step
- Open your HealthCare.gov or state exchange account and check your 2027 eligibility notice for any advance credit shown for a non-eligible family member.
- Update every household member's immigration status on the application so it matches their I-94 or green card.
- Request your and your spouse's 2027 benefits guides before employer open enrollment closes.
- Keep the Form 1095-A your exchange sends by 2027-01-31 and file Form 8962 with your 2026 return.
- Report a green card approval to your exchange and ask whether it changes your 2027 credit.
- Comment on REG-101576-26 at regulations.gov by 2026-11-30 if you want Treasury to hear your household's situation.
Common mistakes
- Assuming a 2026 credit rolls into 2027. The credit ends by statute for H-1B, H-4 and F-1 holders.
- Relying on the old repayment cap. For tax year 2026 any excess is repaid in full, whatever older IRS pages say.
- Treating OPT as different from F-1. OPT and STEM OPT are F-1 status, which Covered California groups under student visas.
- Expecting comments to undo the cut-off. The proposal implements the statute; it does not decide whether the credit exists.
- Letting coverage lapse during a grace period. Price COBRA and the full-price plan the week you get notice.
- Leaving an old status on the application. Report each person's status exactly as their current documents show it.
Frequently asked questions
Can H-1B holders get ACA subsidies in 2027?
No. Under section 71301 of Public Law 119-21, the only noncitizens who can get the premium tax credit for coverage starting in 2027 are green card holders, Cuban and Haitian entrants and COFA migrants, and state exchange summaries place work-visa holders outside that group. The cut-off is scheduled by statute, while Treasury's implementing rules were only proposed on October 15, 2026. H-1B workers can still buy a marketplace plan at full price.
Are F-1 OPT students eligible for marketplace insurance?
Yes for enrollment, no for the 2027 credit. F-1 students, including those on OPT and STEM OPT, can still enroll in a marketplace (Obamacare) plan because they are lawfully present, but Covered California lists student visas among the statuses losing all financial assistance in 2027. For 2026, a lawfully present person with household income below 100% of the federal poverty line who is barred from Medicaid by status is also not eligible for the credit.
What happens to my 2026 premium tax credit at tax time?
You reconcile advance credits on Form 8962 with your 2026 federal return, using the Form 1095-A your exchange sends by January 31, 2027. For tax years beginning after December 31, 2025, the cap on repaying excess advance credits is gone, so any excess is added to your tax in full. If you file Form 1040-NR, ask a tax professional who handles nonresident returns.
What are my options if I lose subsidies between jobs?
Check your own or your spouse's employer plan first, then compare COBRA, which can cost up to 102% of the plan's cost, against a full-price marketplace plan bought in a special enrollment period. A school plan may be an option for students, and short-term plans can exclude pre-existing conditions. In 2027 the marketplace carries no credit for H-1B, H-4 or F-1 holders, so compare full prices.
Who keeps the premium tax credit in 2027?
From January 1, 2027, US citizens and nationals and three groups of noncitizens keep access to the credit if they meet the income and other tests, namely lawful permanent residents, Cuban and Haitian entrants, and people living in the US under a Compact of Free Association. In a mixed-status household, the credit covers only the share of premiums attributable to eligible family members, which Treasury's October 2026 proposal spells out.
Sources
- Treasury and IRS, Premium Tax Credit, proposed regulations, 91 FR 65494 (2026-10-15), also as a govinfo PDF
- Regulations.gov docket IRS-2026-1420 (REG-101576-26)
- Covered California, 2027 Marketplace Eligibility Changes for Certain Lawfully Present Immigrants
- KFF, marketplace FAQ on immigrants and 9 Things to Watch for the 2027 ACA Open Enrollment Period (2026-10-30)
- KFF, Examining Short-Term Limited Duration Health Plans (2025-10-15)
- IRS, The Premium Tax Credit, the basics, claiming the credit and reconciling advance payments, About Form 8962 and About Form 1095-A
- US Department of Labor, Continuation of Health Coverage (COBRA)
- DHS, proposed elimination of the 60-day grace period (91 FR 57807, 2026-09-11)
- SEVP, Broadcast Message 2101-01 on OPT unemployment
- USCIS, guidance on public charge inadmissibility determinations
How we checked this: on 2026-11-01 and 11-02 we read the proposed rule's full text and its Federal Register record, Covered California's fact sheet, three KFF pages, the USCIS public charge guidance and the IRS and DOL pages listed above, and checked every status against our dated facts brief.
This is general information, not legal or tax advice. Your own I-94, notices and exchange eligibility letter govern, and decisions about status belong with your DSO (F-1, OPT, SEVIS) or a licensed immigration attorney, and tax filings with a tax professional who handles nonresident returns.
If a 2027 job change is part of your plan and you want a search built around employers that sponsor and offer employer health plans, talk to F1Jobs.
Frequently asked questions
Can H-1B holders get ACA subsidies in 2027?
No. Under section 71301 of Public Law 119-21, the only noncitizens who can get the premium tax credit for coverage starting in 2027 are green card holders, Cuban and Haitian entrants and COFA migrants, and state exchange summaries place work-visa holders outside that group. The cut-off is scheduled by statute, while Treasury's implementing rules were only proposed on October 15, 2026. H-1B workers can still buy a marketplace plan at full price.
Are F-1 OPT students eligible for marketplace insurance?
Yes for enrollment, no for the 2027 credit. F-1 students, including those on OPT and STEM OPT, can still enroll in a marketplace (Obamacare) plan because they are lawfully present, but Covered California lists student visas among the statuses losing all financial assistance in 2027. For 2026, a lawfully present person with household income below 100% of the federal poverty line who is barred from Medicaid by status is also not eligible for the credit.
What happens to my 2026 premium tax credit at tax time?
You reconcile advance credits on Form 8962 with your 2026 federal return, using the Form 1095-A your exchange sends by January 31, 2027. For tax years beginning after December 31, 2025, the cap on repaying excess advance credits is gone, so any excess is added to your tax in full. If you file Form 1040-NR, ask a tax professional who handles nonresident returns.
What are my options if I lose subsidies between jobs?
Check your own or your spouse's employer plan first, then compare COBRA, which can cost up to 102% of the plan's cost, against a full-price marketplace plan bought in a special enrollment period. A school plan may be an option for students, and short-term plans can exclude pre-existing conditions. In 2027 the marketplace carries no credit for H-1B, H-4 or F-1 holders, so compare full prices.
Who keeps the premium tax credit in 2027?
From January 1, 2027, US citizens and nationals and three groups of noncitizens keep access to the credit if they meet the income and other tests, namely lawful permanent residents, Cuban and Haitian entrants, and people living in the US under a Compact of Free Association. In a mixed-status household, the credit covers only the share of premiums attributable to eligible family members, which Treasury's October 2026 proposal spells out.