The IRS and Treasury proposed new premium tax credit rules on October 15, 2026, and you can comment until November 30, 2026. The biggest money change is already in the law: starting with the 2026 tax year, there is no cap on how much extra ACA subsidy you must repay. If your advance payments turn out to be too high, you owe the full difference when you file.
Key takeaways
- The proposed rule was published October 15, 2026. Comments are due November 30, 2026, and a phone hearing is set for December 8 at 10 a.m. ET.
- For tax years beginning after December 31, 2025, the cap on repaying excess advance premium tax credit payments is gone. You repay the full excess.
- Starting with plan years after 2025, plans you join through a special enrollment period based on a change in your expected income do not qualify for the credit.
- A new Marketplace verification step applies to tax years beginning after December 31, 2027. It checks your eligibility before a month counts for the credit.
- These are proposed rules, not final ones. The IRS can change them after it reads the comments.
If you get help paying for health insurance through the ACA Marketplace, a new IRS proposal matters to you. On October 14, 2026, the Treasury Department and IRS announced proposed premium tax credit rules. The Federal Register printed them the next day.
Here is the plain-English version. The proposal turns changes from the 2025 law (the “One, Big, Beautiful Bill Act,” or OBBBA) into detailed IRS rules. Most of the money changes are already in the law itself. The proposal explains how the IRS plans to apply them.
What is the premium tax credit?
The premium tax credit (PTC) is a refundable tax credit. It helps people with income in the eligible range pay for a plan from the Marketplace, which the rules call an Exchange. You can get it in advance, as a lower monthly premium. Those are called advance payments, or APTC. Or you can claim it all when you file your return.
Either way, you settle up on your tax return. The Marketplace sends you a Form 1095-A with your plan details, and you compare the advance payments you got with the credit you are actually allowed.
What changes if you got too much help?
This is the change most people will feel. Before, the law limited how much extra credit some people had to pay back. The proposed rule says that limit is gone for tax years beginning after December 31, 2025. That means your 2026 tax return, which you file in 2027.
In the IRS’s words, when you reconcile, “the full amount by which APTC exceeds PTC” adds to your tax bill. Reconcile is the tax term for comparing what you got with what you were allowed.
Here is an illustration with made-up numbers:
- Advance payments during 2026: $300 × 12 months = $3,600
- Credit you are allowed once your real income is known: $1,500
- Excess you repay: $3,600 − $1,500 = $2,100
Before the cap went away, some people owed less than the full excess. For tax years beginning after 2025, the full $2,100 is added to your tax. Your own numbers will differ.
What else is in the proposed rules?
The proposal covers several changes. This table lists the ones most likely to affect a household. All dates come from the Federal Register notice.
| Change | When it applies |
|---|---|
| No cap on repaying excess advance payments | Tax years beginning after Dec. 31, 2025 |
| People lawfully present in the U.S. with income under 100% of the poverty line who can’t get Medicaid because of immigration status no longer qualify for the credit | Tax years after Dec. 31, 2025 |
| A plan joined through a special enrollment period tied to a change in expected income is not a qualified health plan | Plan years beginning after Dec. 31, 2025 |
| Exchange must verify eligibility before a month counts for the credit | Tax years beginning after Dec. 31, 2027 |
| Premiums for family members who are not eligible are left out of the credit math and the Form 1095-A | Tax years beginning after Dec. 31, 2026 |
A special enrollment period is a window outside open enrollment that opens after certain life events. The notice says that for plan years beginning after December 31, 2025, a plan you enroll in during an income-based special enrollment period does not count as a qualified health plan for the credit. Check HealthCare.gov for how this applies to your situation.
What about Medicaid work requirements?
The 2025 law also added “community engagement” rules for some adults on Medicaid. In general, that means working, volunteering, doing a work program or going to school at least half-time for 80 hours a month. States must start these rules by January 1, 2027, unless the federal government gives a state a good-faith delay that cannot run past December 31, 2028.
The IRS proposal covers one tax result. If the Marketplace finds you are ineligible for Medicaid only because you did not meet this requirement, you are treated as eligible for Medicaid coverage. The months you were ineligible for that reason do not count as coverage months for the credit. If you later become ineligible for Medicaid for a different reason, such as higher income, you may qualify for the credit from that point.
Does this change what you pay for 2027 coverage?
Not directly. The percentages that set your expected payment for 2027 were already published, and we cover them in our ACA open enrollment 2027 guide. What the new rules change is the settle-up after the year ends.
That makes your income estimate more important. If you guess too low in November, your advance payments could be too big. Under the repayment rule above, you could owe all of the difference next spring. If you guess too high, you may pay more each month than you needed to. Use our income tax calculator to estimate your 2027 income, and see the federal poverty level page for the income lines the credit depends on.
Are these rules final?
No. They are proposed rules. The IRS will read public comments and may change them before it issues final ones. Key dates:
| Date | What happens |
|---|---|
| November 30, 2026 | Comments are due. Requests to speak at the hearing, with an outline, are also due. |
| December 4, 2026 | Requests to attend the hearing are due by 5 p.m. ET. |
| December 8, 2026 | Phone hearing at 10 a.m. ET. |
The notice says that if no outlines arrive by November 30, the hearing will be cancelled. To comment, go to regulations.gov and use IRS and REG-101576-26. Comments cannot be edited or withdrawn after you submit them, and the IRS will make them public.
What to do now
- Check your current advance payments. Log in to your Marketplace account and see how much credit you get each month in 2026.
- Update your 2026 income if it changed. A raise, a new job or side income can make your advance payments too big. Fixing it now can reduce what you owe next spring. Our budget calculator can help you plan.
- Plan for the repayment rule. For the 2026 tax year, set aside money in case your final credit is lower than what you received in advance.
- Mark open enrollment. HealthCare.gov says open enrollment for 2027 runs November 1 to January 15, with December 15 as the deadline for January 1 coverage.
- Keep your Form 1095-A. You will need it to file your 2026 return in early 2027.
- Comment if you want to be heard. The deadline is November 30, 2026.
This article is general information, not tax or legal advice. Your situation can change the result, so check your Marketplace notices or talk to a tax professional.
Frequently asked questions
What is the premium tax credit?
The premium tax credit is a refundable tax credit that helps eligible people pay for health insurance bought through the ACA Marketplace, also called the Exchange. You can take it as lower monthly premiums during the year, called advance payments, or claim it all when you file your tax return. Either way, you settle up on your return using Form 1095-A from the Marketplace.
Do I have to pay back advance premium tax credit payments?
Yes, if the advance payments you received are larger than the credit you are allowed once your actual income is known. You report this on your tax return. For tax years beginning after December 31, 2025, the law no longer limits how much of that excess you repay, so the full amount adds to your tax bill.
When are the proposed premium tax credit rules final?
They are not final yet. The IRS published the proposed rules in the Federal Register on October 15, 2026, and will accept comments until November 30, 2026. A public hearing is set for December 8, 2026. After reviewing comments, the agency can change the rules before it issues final ones. No final date has been announced.
How do I comment on the proposed IRS rule?
Go to regulations.gov and enter IRS and REG-101576-26. The IRS strongly encourages electronic comments, and they must arrive by November 30, 2026. Once you submit a comment, it cannot be edited or withdrawn. To speak at the December 8 hearing, send a request and an outline of your topics by November 30.
Does this change what I pay for 2027 coverage?
Not directly. The proposed rule explains how the IRS will apply laws that already passed, and it does not change the premium table for 2027. What can change your bill is the full-repayment rule if you estimate your income too low, so keep your income estimate current on your Marketplace application.
How do I avoid owing money back on my ACA subsidy?
Estimate your income as carefully as you can when you apply, and update the Marketplace when it changes, such as after a raise, a new job or a side income. A better estimate means your advance payments are closer to the credit you are actually allowed, so there is less to repay when you file.