As independent contractors, most REALTORS® purchase their own health insurance through the Affordable Care Act (ACA) Marketplace. The enhanced premium subsidies that have lowered monthly costs for many self-employed professionals are set to expire at the end of 2025 unless Congress acts to extend them. If those subsidies lapse, middle-income households could face higher premiums starting in 2026, and the previous “subsidy cliff” could return, limiting eligibility for many agents and small brokerage owners.
Now is the time to understand how these changes could affect your coverage, budget, and tax strategy. The FAQs below outline what to expect and how to plan ahead for 2026.
Frequently Asked Questions: 2026 Health-Care Changes and What REALTORS® Should Know
Eligibility & Income Planning
Q: My real estate income fluctuates month to month. How do I estimate my income for Marketplace subsidies?
A: Use your expected annual Modified Adjusted Gross Income (MAGI), your best estimate of total taxable income for the year. Include commissions, side income, and your spouse’s income if you file jointly. If your income varies widely, average recent years or estimate conservatively, then update your Marketplace application midyear if your income changes significantly to avoid owing money back at tax time.
Q: Can I lower my income to stay under the subsidy threshold?
A: Potentially, yes. Legitimate business deductions, retirement contributions (SEP-IRA, Solo 401(k)), and HSA deposits reduce your MAGI. This can help you stay under 400% of the Federal Poverty Level (the “cliff” threshold if subsidies expire). Work with a tax professional to time deductions appropriately-don’t reduce income just for the sake of subsidy eligibility without considering the full tax picture.
Q: Does my spouse’s separate business income count?
A: Yes. The Marketplace bases subsidy eligibility on total household income, not just one person’s. If your spouse runs a separate business or earns W-2 income, include it when estimating your MAGI.
Q: If I switch from sole proprietor to S-corp, does that change my subsidy?
A: It can. S-corp owners must report wages and distributions differently, which may affect your reported income and deductible expenses. Talk to both your accountant and insurance advisor before making the change, sometimes incorporating helps manage self-employment taxes but may reduce certain deductions that keep income lower for subsidy purposes.
Premium Cost Scenarios
Q: How much could my premiums increase if Congress doesn’t renew the subsidies?
A: Estimates vary by income and plan, but many Marketplace participants could see 20%–80% higher premiums. A family earning around $100,000 might pay $400–$600 more per month, while higher earners may lose eligibility entirely. Use the KFF Subsidy Calculator to run 2026 scenarios.
Q: Will my 2025 plan automatically renew at the same rate?
A: No. Even if you take no action, your plan will renew at 2026 rates, which may change significantly if subsidies expire. Always log in during Open Enrollment (Nov 1–Dec 15) to review updated costs and confirm coverage.
Coverage & Plan Management
Q: What’s the difference between Bronze, Silver, and Gold plans?
A:
- Bronze = lowest premiums, higher deductibles (best for healthy individuals).
- Silver = balanced costs, eligible for cost-sharing reductions (if those return).
- Gold = higher monthly premiums, lower out-of-pocket costs.
Realtors who rarely visit the doctor often pair Bronze HDHPs with an HSA for tax savings.
Q: Are telehealth visits still covered before the deductible?
A: Yes. Congress made the telehealth safe harbor permanent for HSA-eligible high-deductible plans. You can use telehealth without meeting your deductible and still keep HSA eligibility.
Q: Will preventive care still be free?
A: Yes. Under ACA rules, preventive services (like annual physicals, vaccines, and screenings) remain no-cost when done in-network, regardless of subsidy status.
Q: I travel a lot for showings. What kind of plan works best?
A: Look for PPO or nationwide network plans that allow out-of-state coverage. Many Marketplace plans are HMOs with limited local networks, so check coverage for out-of-area emergencies or short-term travel health plans.
Small Brokerages & Team Leaders
Q: Can I reimburse my agents for their own Marketplace premiums?
A: Generally, no for independent contractors, it risks being seen as an employer plan. Instead, you can increase commission splits or stipends and let agents buy their own coverage. If you have W-2 employees, consider a QSEHRA (for under 50 employees) or ICHRA to reimburse premiums tax-free.
Q: What’s the difference between ICHRA and QSEHRA?
A:
- QSEHRA – for small employers (under 50 employees); simple, capped annual reimbursements.
- ICHRA – for any size employer; flexible, can offer different amounts by class (e.g., full-time vs part-time).
Both require employees to buy individual Marketplace coverage and submit proof of insurance.
Q: At what point am I required to offer group health insurance?
A: Federal law requires employers with 50 or more full-time equivalents to offer affordable group coverage or face penalties. Independent contractors (1099s) don’t count toward that total.
Tax & Filing Implications
Q: What happens if my actual income is higher than I estimated?
A: You’ll need to repay part or all of the excess subsidy when filing your taxes. The IRS will reconcile the advance tax credits based on your actual MAGI. Avoid surprises by reporting income changes midyear.
Q: Can I pay back subsidy overages in installments?
A: Not directly. The full repayment (up to IRS limits) is due with your tax filing, but you can adjust withholding or make quarterly estimated payments to soften the blow.
Q: When will I get my 1095-A form?
A: The Marketplace sends Form 1095-A by late January. You’ll use it to complete Form 8962, which reconciles your subsidy on your tax return. Keep copies for your records, lenders sometimes request proof of coverage during closings or loan applications.
Q: Does filing my taxes late affect next year’s subsidy?
A: Yes. The Marketplace may pause or deny premium credits if you fail to file or reconcile prior-year subsidies. Always file on time, even if you owe.
Timing & Planning
Q: When should I start reviewing plans for 2026?
A: Begin as early as October 2025 when rates are published. Open Enrollment runs Nov 1–Dec 15 (dates can vary slightly by state). Waiting until December can limit your options if plans sell out or networks change.
Q: If I’m happy with my plan, can I do nothing?
A: You can, but it’s risky. Plans change every year, and if subsidies expire, your automatic renewal could come with a large rate increase. Always log in to confirm or adjust.
Good News
Q: Are surprise medical bills coming back?
A: No. The No Surprises Act still protects you from most unexpected out-of-network hospital or emergency bills. The rules are being refined, but the core consumer protections remain in place.
Q: Are there any permanent benefits?
A: Yes. The telehealth pre-deductible rule for HSA plans is now permanent, preventive care stays no-cost, and the ACA Marketplace itself isn’t going anywhere, only the enhanced subsidies are at risk of expiring.
Next Steps for REALTORS®
Even if you’re satisfied with your current coverage, take time this fall to evaluate how the expiring subsidies could impact your budget. Review your projected 2025 income, explore HSA-compatible plans, and talk with your CPA or insurance advisor about strategies to manage costs. If you run a brokerage or small team, consider whether an ICHRA or QSEHRA could provide flexibility for 2026 and beyond.
Staying informed and proactive will help you avoid last-minute surprisesand ensure you’re protected, healthy, and financially prepared for the year ahead.