About the ACA healthcare cost estimator

Most healthcare cost tools quote you today's premium and stop there. That's the least useful number in early retirement planning. ACA rules let insurers charge a 64-year-old three times what a 21-year-old pays, which means your premium at 60 will look nothing like your premium at 40 — and the years right before Medicare are exactly the years a lean FIRE portfolio is most exposed. This tool projects your household's full healthcare cost, year by year, from your current age to Medicare at 65, then calculates the extra portfolio buffer you need above your 4% Rule number to fund the gap. Every assumption is adjustable and every source is cited.

What it estimates

• Unsubsidized ACA premiums for your household using 2026 plan-year data from the CMS Public Use Files — actual silver benchmark (SLCSP) and lowest-bronze rates by age and rating area for the 30 federal-exchange states, with published 2026 state averages for the 21 state-based exchanges
• Household composition done right: a spouse rated at their own age, up to four children, the ACA three-child premium cap, and dependents stepping off your plan at 26
• Out-of-pocket costs — deductibles, copays, coinsurance, and prescriptions — by age, from the federal Medical Expenditure Panel Survey, with a 30% uplift applied to bronze plans
• A stress test that replaces your highest-cost years with the ACA max out-of-pocket ($10,600 individual / $21,200 family for 2026), because population averages hide bad years
• Premium growth above inflation, adjustable from 0 to 4% and defaulting to 1.5% real
• An optional premium tax credit scenario under post-2025 rules, including the 400% of federal poverty level eligibility cliff
• A manual override that anchors the whole projection to your actual healthcare.gov quote
• The bottom line: the present value of every dollar your future costs exceed today's, discounted at your chosen real return — the buffer to add to your FIRE number
• Tobacco surcharges, plus correct handling of community-rated states (NY and VT have no age curve at all; MA compresses it to 2:1)

What changed for 2026

Two things make this plan year different. First, the enhanced premium tax credits expired at the end of 2025, so the 400% FPL subsidy cliff is back: one dollar of income over the line and the entire credit disappears. The tool models the cliff and warns you when you're within 10% of it. Second, benchmark premiums jumped roughly 26% nationally for 2026 — the largest single-year increase in the program's history — which is why the tool defaults to premium growth above inflation rather than assuming costs track CPI. The default view is deliberately unsubsidized: counting on credits that depend on income management and the political weather is a fragile assumption for a 25-year plan. The subsidized scenario is one toggle away if you want to see the comparison.

How to use it

Enter your age, your spouse's age, and each child's age, then search your ZIP code or city. The estimate, the hump chart, and the buffer calculation update instantly. Pick silver or bronze, toggle the out-of-pocket estimate, and open the advanced assumptions to set premium growth, run the stress test, test a subsidy scenario against your planned MAGI, or anchor everything to a real quote. The chart's dashed vertical lines mark the years each child ages off your plan; the rust dots mark stress-test years. When you're done, copy a plain-text summary of your result. The methodology section at the bottom shows every source and constant. 

Frequently asked questions

What is the healthcare hump? ACA premiums rise steeply with age — federal rules allow a 64-year-old to be charged three times what a 21-year-old pays. For early retirees, that creates a growing annual cost between retirement and Medicare at 65 that the standard 4% Rule does not capture. This tool sizes that gap and the extra portfolio buffer needed to fund it.

What plan year does the estimator use?

The 2026 ACA plan year. Premiums come from the CMS 2026 Health Insurance Exchange Public Use Files for the 30 federal-exchange states, with state-level 2026 benchmark estimates for the 21 state-based exchanges. Out-of-pocket estimates come from the AHRQ Medical Expenditure Panel Survey.

Does it include premium tax credits (subsidies)?

By default, no — it shows worst-case unsubsidized costs, because relying on subsidies is a risky long-horizon planning assumption. You can toggle on a premium tax credit scenario that applies the post-2025 rules, including the 400% FPL eligibility cliff that returned when the enhanced credits expired at the end of 2025.

Is the estimator free, and where does my data go?

It is free and runs entirely in your browser. All inputs are calculated locally and are not sent anywhere.

Can I use it to choose or buy a health plan?

No. It is a planning estimate, not insurance advice and not an enrollment tool. Actual plan costs vary by specific plan, network, and county. Always verify current rates at healthcare.gov or your state exchange before making coverage decisions.

This estimator is for educational and planning purposes only. It is not insurance, financial, or tax advice, and it does not replace a conversation with a licensed insurance agent or financial planner.