The ACA Marketplace was always the default answer for agents when they were looking for their own health insurance. In 2026, the math behind that default changed, and many agents are now weighing alternatives to find a better fit.
What is a health insurance premium tax credit?
According to the IRS, “The premium tax credit – also known as PTC – is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace. To get this credit, you must meet certain requirements and file a tax return with Form 8962, Premium Tax Credit (PTC).” This means that when you qualify for the tax credit, you are paying much less for health insurance per month than what you would normally have to pay if you buy on the ACA Marketplace.
What changed on January 1, 2026?
Since 2021, enhanced premium tax credits had lowered what enrollees paid at every income level and removed the income cap on eligibility, so even households above 400% of the federal poverty level received help. Those enhancements ended in 2025, and the original rules came back. Three things changed at once:
- Less subsidies: Enrollees at every income level now need to pay more toward premiums than last year.
- The income cap returned: A household even one dollar over 400% of the poverty level receives no credit at all.
- Increased rates: Insurers separately raised base premiums about 26% on average for 2026.
KFF, the independent source for health policy research and news, estimated that a subsidized enrollee keeping the same plan would pay 114% more this year. In practice, many people downgrade to bronze plans (or plans with the least coverage options) with higher deductibles, and those who lost credits entirely often left the Marketplace. Even so, the average premium payment after credits rose 58%, from $113 to $178 per month, across the country. That’s not all - average ACA Marketplace deductibles increased by 37% (or $1,027 per person) to a record high of $3,786 in 2026, making the ACA options seem even less appealing.
What does this mean for me and my income?
Below the income qualifying line, agents still get credits, just smaller ones. The tricky part is that the subsidy is based on the projected income, and as you know as a real estate agent, commission income is hard to predict. NAR puts median gross agent income at $58,100, which for a smaller household sits close enough to the cutoff that one strong quarter can push over it, sometimes making you to pay back part of the subsidy at tax time.
Above the income qualifying line, the change is bigger. The enhanced credits used to cap the premiums at about 8.5% of income no matter how high they ran. That cap is gone. Now agents over the line pay the full sticker price, and the sticker itself just rose 26%. Older agents feel it most, since unsubsidized premiums climb with age in most states. This is the group most actively looking at alternatives right now.
The alternatives, and who each one fits
1. COBRA
If you just left a W-2 job with group coverage, you could keep the plan by paying the entire premium, including the share your employer used to cover, plus a 2% fee. It’s a good fit if you are mid-treatment or halfway into your deductible for the year and don’t want to switch doctors, or if you just need something to carry until a longer-term plan is in place. However, it is not a permanent solution: the clock runs out at 18 months, and it is usually the priciest option per month, because it keeps employer-grade coverage without the employer paying for it.
2. Health sharing ministries
In a health sharing plan, you pay a monthly share amount, typically well below an insurance premium, and the members’ pooled money covers eligible bills. It works for healthy, price-driven agents who understand exactly what they are buying and accept the tradeoff. But they are dangerous in that they do not fit anyone who needs guaranteed coverage: health shares carry no legal obligation to pay any claim, commonly exclude pre-existing conditions, and often cap what they will share per incident or per lifetime.
3. Short-term plans
For agents, the classic moment for this plan type is during the career switch to becoming an agent. You’ve left your job to go full-time into real estate, COBRA is too expensive and your first commissions have not landed yet. A short-term plan can be a low-cost bridge. It fits healthy agents but does not fit anyone with an ongoing condition, since these plans are underwritten and routinely exclude pre-existing conditions, and they are not built to serve as year-round major medical.
Where it gets complicated for a brokerage like NextHome is that state rules decide whether this option exists at all. California bans short-term plans outright, New York limits them to roughly three months, while Florida and Texas permit them. Two NextHome agents in the same situation can face completely different options depending on their state. Find out what’s available in your state first.
4. Business-of-one plans
Business-of-one plans let your own business, under its own EIN, LLC or S-Corp, set up a health plan the way an employer does, just scaled down to a business of one.
If you run your business as an LLC or a sole proprietorship with an EIN, you are eligible. Another benefit of a business-of-one plan is that you can generally tax deduct your monthly premiums as a business expense, leading to even more cost savings.
These are real major medical plans with PPO networks. The structure is what makes them different: your business establishes its own health plan, built around you as the owner, rather than buying a seat in someone else's. The health questionnaire shapes the rest. Because every member joins through that questionnaire, there's no open enrollment window to wait for. You can join any time of year, with coverage starting on the 1st of the month. And because everyone in the pool has passed the same screening, the pool stays healthier, which is what keeps monthly costs down.
That tradeoff also defines who this does not fit: an application can be declined, so an agent managing a pre-existing condition that disqualifies them from a business-of-one plan may decide to stay on the Marketplace, where you get covered regardless of health history.
How should I decide what plan to buy?
Whichever category fits, the goal is the same: making the coverage decision with the full picture in front of you.
- Income relative to the 400% line. Meaningful subsidies may still make the Marketplace the best value. Above the line, the case for comparing alternatives is strongest.
- State of residence. State rules decide which categories exist at all. Check what is sold locally before comparing prices.
- Time horizon. A short gap points to COBRA or a short-term plan. A permanent arrangement points to the Marketplace or a business-of-one plan.
What is NextHome’s healthcare option?
NextHome has partnered with RLTYco to provide health coverage through its division RLTYhealth.
To enroll, you can either:
- Wait until Open Enrollment (usually November 1st-January 15th depending on your state) and call the dedicated United Healthcare phone number linked here to explore 200+ carrier plans OR
- Get a free quote from Solo Health, RLTYhealth’s business-of-one plan
Solo Health is comprehensive major medical coverage on the MultiPlan PHCS network, with 1.4 million+ providers nationwide plus out-of-network coverage. Spouses and dependents are welcome to join, and mental health support is built in. You choose from three deductible options ($2,500, $5,000, or $10,000), and your deductible is also your out-of-pocket maximum. No coinsurance, ever. The two lower tiers are HSA-eligible, giving agents a plan that can lower monthly costs without lowering the bar on coverage.
Monthly premium costs are based on your age, gender, and location - get a free quote in seconds here. Agents qualify by using their active EIN and passing a brief health questionnaire – book a call with a licensed insurance agent today!