The ACA Marketplace is a government-run service where individuals and families can shop for, compare, and enroll in health insurance plans. Created by the Affordable Care Act (often called “Obamacare”), it launched in 2014 to give people without employer-sponsored coverage a single place to find plans that meet minimum coverage standards and, in many cases, qualify for financial help paying premiums.
Most states use the federal platform at HealthCare.gov, while 21 states (plus Washington, D.C.) operate their own marketplace websites. Regardless of which version your state uses, the plans offered, the financial assistance available, and the enrollment rules work the same way.
How the Marketplace Works
When you apply through the Marketplace, you enter information about your household size and estimated income. The system then determines whether you qualify for premium tax credits that lower your monthly cost, cost-sharing reductions that lower your out-of-pocket expenses, or coverage through Medicaid or the Children’s Health Insurance Program (CHIP). You can browse available plans, compare what each one covers and costs, and enroll online, by phone, or with in-person assistance.
Small businesses have a separate option called the Small Business Health Options Program (SHOP), which lets employers offer health coverage to their workers through the same system.
Who Can Enroll
Eligibility is straightforward. You must live in the United States, be a U.S. citizen, U.S. national, or lawfully present noncitizen, and not be currently incarcerated. Residents of U.S. territories generally cannot use the Marketplace unless they also qualify as a resident of one of the 50 states or D.C.
There are no health screenings or medical history requirements. Marketplace plans cannot deny you coverage or charge you more because of a pre-existing condition.
The Metal Tier System
Marketplace plans are organized into four categories named after metals. The categories reflect how costs are split between you and the insurance company, not the quality of care you receive.
- Bronze: The plan covers about 60% of costs, you pay 40%. Deductibles are generally high, but monthly premiums are the lowest. Best if you’re healthy and mainly want protection against a major medical event.
- Silver: The plan covers about 70%, you pay 30%. Moderate deductibles. Silver is also the only category that qualifies for extra cost-sharing reductions if your income is low enough.
- Gold: The plan covers about 80%, you pay 20%. Low deductibles, higher monthly premiums. A solid choice if you use healthcare regularly.
- Platinum: The plan covers about 90%, you pay 10%. The highest premiums but the lowest costs when you actually get care.
A Silver plan with cost-sharing reductions can cover anywhere from 73% to 94% of your costs depending on your income, making it function more like a Gold or Platinum plan at a Silver-level premium. This is one of the most overlooked benefits in the Marketplace.
What Every Plan Must Cover
All Marketplace plans are required to cover ten categories of essential health benefits. These include outpatient care, emergency services, hospital stays, maternity and newborn care, mental health and substance use treatment, prescription drugs, rehabilitative services and devices, lab tests, preventive care and chronic disease management, and pediatric services (including dental and vision for children). Preventive services like annual checkups, certain screenings, and vaccinations are covered at no cost to you, even before you meet your deductible.
Financial Assistance
Two types of financial help are available through the Marketplace, and many people qualify for both.
Premium Tax Credits
These reduce your monthly premium. To qualify, your household income generally needs to fall between 100% and 400% of the federal poverty level. For 2024 and 2025, expanded subsidies introduced by the American Rescue Plan and extended by the Inflation Reduction Act removed the 400% cap, meaning even higher-income households could get some help if premiums would otherwise consume a large share of their income. These expanded subsidies are set to expire at the end of 2025, which could significantly raise costs for millions of enrollees starting in 2026 if Congress does not act to renew them.
You can take the credit in advance so it lowers your bill each month, or claim it when you file your taxes.
Cost-Sharing Reductions
These lower your deductibles, copays, and coinsurance. They’re only available if you pick a Silver plan. The lower your income within the qualifying range, the more you save. You won’t see these savings reflected in plans from other metal tiers, even if you qualify for premium tax credits on those plans.
When You Can Enroll
Open Enrollment runs from November 1 through January 15 each year. This is the window when anyone eligible can sign up for a new plan or switch their existing one. If you miss it, you’ll generally need to wait until the next Open Enrollment period.
The exception is a Special Enrollment Period, which gives you 60 days to enroll outside the normal window after a qualifying life event. Common qualifying events include:
- Losing existing coverage from a job, a parent’s plan (turning 26), Medicaid, or another source
- Household changes like getting married, getting divorced, having a baby, or adopting a child
- Moving to a new ZIP code or county
- Income changes that affect what coverage you qualify for
- Other events like becoming a U.S. citizen, leaving incarceration, or gaining membership in a federally recognized tribe
Federal vs. State Marketplaces
If your state runs its own marketplace, you’ll use that state’s website instead of HealthCare.gov. States like California (Covered California), New York (NY State of Health), and Colorado (Connect for Health Colorado) are examples. Some states run their own marketplace but still rely on the federal platform for enrollment and eligibility functions behind the scenes.
For the 2026 plan year, 21 states operate fully independent exchanges, 3 states use a hybrid model built on the federal platform, and the rest use HealthCare.gov directly. The plans and subsidies available to you depend on where you live, not which platform your state uses. If you’re unsure which applies to you, starting at HealthCare.gov will redirect you to the right place.