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Pennsylvania · licensed here · 2026 plan year

What Are the Pennie Income Limits for 2026? Pennsylvania's Medicaid, CHIP, and Tax Credit Lines by Family Size

Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published September 4, 2026

🔍 Find my family's lines 📊 The full 2026 table 🧮 Estimate my tax credit in dollars

For 2026 coverage, Pennie gives a federal premium tax credit to households between 100% and 400% of the poverty level: $15,650 to $62,600 for one person and $32,150 to $128,600 for a family of four. Pennie's own phrasing: earn around $62,600 or more as a single person, or $84,600 as a couple, and you get no tax credit at all. Adults under 138% ($22,025 single, $45,540 for four) go to Medical Assistance, Pennsylvania's Medicaid. Kids get CHIP free up to 208% of poverty, low-cost to 314%, and full-cost with no income cap. Pennsylvania adds no state subsidy on top, which is why the 2026 renewal hit harder here than in New York, California, or Maryland. Every line for households of one to eight is below, then the doors if you are over the top one. I educate, you decide.

The full Pennsylvania income chart for 2026

Three programs, two poverty tables. Pennie's tax-credit range for 2026 coverage runs on the 2025 poverty guidelines ($15,650 for one person plus $5,500 each), because the federal rule sets a plan year's eligibility with the prior year's table. Medical Assistance and CHIP run on the 2026 guidelines ($15,960 plus $5,680), with CHIP's new levels effective March 1, 2026.

Sources: Pennie, what's new for 2026; PA Department of Human Services, federal poverty income guidelines; PA DHS, CHIP income guidelines effective March 1, 2026. CHIP: children ages 1 to 5 below 157% and ages 6 to 18 below 133% go to Medical Assistance; low-cost CHIP has three premium steps (208% to 262%, 262% to 288%, 288% to 314%). For 2027 coverage the tax credit table moves to the 2026 guidelines: $63,840 for one and $132,000 for four at the cliff.

Why Pennsylvania feels the cliff harder: no state subsidy

California put $190 million into a state subsidy. Maryland built a program that replaces the lost enhanced credit for most enrollees. Pennsylvania did neither. What Pennsylvania has is a reinsurance program under Act 42 of 2019, run through Pennie and extended through 2030, which pays part of the biggest claims and lowers everyone's individual-market premium by about 4% for 2026. A State Health Insurance Exchange Affordability Program was created by Act 54 of 2024, and it is a real law, but as of Pennie's August 2026 update it has no money in it. Pennie's estimate: $50 million a year, about a twelfth of the $600 million in federal credits Pennsylvanians lost, would cut premiums 9% to 12% for more than 280,000 enrollees and bring back roughly 48,000 of the people who left. Until Harrisburg funds it, the only help on Pennie is the federal credit in the table above.

Sources: Pennsylvania Insurance Department, Act 42 reinsurance waiver; Pennie, affordability program update.

What Pennie plans cost in 2026, and who left

Sources: KFF, 2026 benchmark premiums; Pennsylvania Insurance Department, October 14, 2025.

Insurers first proposed a 19% average increase for 2026. Then Congress let the enhanced credits lapse, they refiled, and on October 14, 2025 the Insurance Department approved 21.5% for the individual market (a range from a 10.1% decrease to a 37.8% increase depending on the company), after blocking $50.1 million in increases it found unjustified. The reasons it listed: the expiring federal credits, new federal enrollment rules, rising medical and drug costs, and a sicker pool in some rating areas. For households that had been getting the enhanced credit, Pennie reported renewal premiums roughly doubled on average. The result showed up in the count. Pennie hit a record 497,000 enrollees at the end of the 2025 open enrollment, closed the 2026 open enrollment near 486,000, and by June 1, 2026 the state's Independent Fiscal Office counted about 160,000 total departures. About one in five enrollees who had the enhanced credit dropped coverage.

Sources: Pennie, one in five enrollees drop coverage; Pennsylvania Capital-Star on the IFO count.

Medical Assistance changes coming January 1, 2027

Pennsylvania expanded Medicaid in 2015, so adults qualify up to 138% of poverty with no asset test. Two federal changes from the July 2025 law land on January 1, 2027: a work or community engagement requirement of 80 hours a month for expansion adults ages 19 to 64 without a dependent child under 14 (with exemptions for pregnancy, disability, caregiving, and serious conditions), and eligibility renewals every six months instead of twelve. The Department of Human Services began mailing notices in August 2026 to more than 700,000 expansion enrollees. If you are near the $22,025 line as a single person, the practical effect is that income that drifts above it, plus a missed six-month renewal, can put you on Pennie mid-year with a credit you did not plan for. Report the change the month it happens.

Source: PA Department of Human Services, Medicaid changes.

Open enrollment and special enrollment on Pennie

Pennie's published annual open enrollment runs November 1 through January 15, with December 15 the deadline for coverage starting January 1. One caution for 2027: Pennie's board discussed a shorter window earlier in 2026, before a federal court struck down the rule that would have shortened open enrollment nationally in June, so confirm the dates on pennie.com before you plan around them, and check my 2027 dates page, which I update when they are final. Outside the window you need a qualifying event reported within 60 days, with documents due within 90 days, and Pennie now requires proof of prior coverage for some events. The special enrollment period for households under 150% of poverty has been removed.

Source: Pennie FAQ.

Over the line in Pennsylvania? More doors than New York

Here is the part that makes Pennsylvania different from New York, where I sit. Pennsylvania allows medically underwritten private plans. A healthy household earning $135,000 that just watched its Pennie credit go to zero is not stuck paying the community-rated sticker price; it can be priced on its own health, and for healthy people that number is often meaningfully lower than an unsubsidized marketplace plan with a real PPO network attached. The second door is a pre-established ERISA group plan at group rates. Short-term plans exist too, but the Insurance Department still holds them to three months plus one renewal, so they are a gap-filler, not a plan. I walk through all four doors on the Pennsylvania self-employed guide, and the layoff version on the Pennsylvania COBRA alternatives page. Pennsylvania has 955,359 businesses with no employees and a median household income of $77,545, which means the typical family of four is well under the $128,600 line and the two-earner professional household is right on it. If you are within $10,000 of it, a Solo 401(k) or SEP contribution, run with your tax professional, is the first lever to pull.

Sources: Pennsylvania Insurance Department Notice 2018-08; healthinsurance.org, Pennsylvania short-term rules (November 2025); Census median household income, Pennsylvania; Census QuickFacts, Pennsylvania nonemployer establishments 2023.

Common questions about Pennie income limits