When Your Spouse Has Job Coverage: The Family Glitch Fix and Self-Employed Families
If you're self-employed and your spouse has health insurance through work, you may have been told your family can't get help on the Marketplace. That's not always true. A rule change that took effect in 2023, often called the "family glitch" fix, changed how family coverage is judged.
Own a business with 2+ employees? A group plan may cost less (rules vary by state).
This guide explains how the rule works for 2027, what it means for self-employed families, and how to compare your options.
What the family glitch fix changed
Since 2023, job-based coverage is judged differently for the employee and for family members:
- For the employee, the job-based plan is generally affordable if the employee's share of the premium for self-only coverage doesn't exceed a set percentage of household income.
- For family members (like a self-employed spouse and the children), the plan is generally affordable only if the employee's share of the premium for family coverage doesn't exceed that same percentage of household income.
For plan years beginning in 2027, that percentage is 10.22% of household income.
So if covering the whole family through your spouse's job would cost more than 10.22% of your household income, you and your children may be able to get Marketplace help, even though your spouse stays on the job-based plan.
How Marketplace help works in 2027
- The enhanced premium tax credits (2021–2025) expired Dec 31, 2025 and have not been renewed.
- Your expected contribution toward the benchmark Silver plan is 2.15% to 10.22% of income for 2027.
- There's no premium tax credit above 400% of the poverty level: $63,840 for one person and $132,000 for a family of four.
- Florida and Texas have not expanded Medicaid. Households under 100% of the poverty level generally get no Marketplace savings.
Our guide to the 2027 subsidy cliff explains what happens near the 400% line.
Counting household income
The Marketplace counts the expected income of everyone in your tax household, including a spouse's wages and dependents who are required to file a tax return. For the self-employed spouse, report your net self-employment income, which is your business income minus your business expenses. That's the same profit you report on Schedule C.
If your actual income is higher than you estimated, some or all of the credit may have to be repaid at tax time, so report income changes. There's no longer a repayment cap. Starting with tax year 2026, if the advance credit paid to your insurer was more than the credit you qualify for, you have to repay the full difference when you file.
See our guide to estimating self-employed income for help.
The self-employed deduction catch
If your spouse's employer offers subsidized family coverage, the self-employed health insurance deduction on Form 7206 isn't allowed for the months you were eligible for that plan, even if you buy your own policy. The deduction is also limited to your net profit. Our Florida self-employed health insurance guide covers more.
How to compare
- Get the cost of family coverage from your spouse's employer (the employee's share).
- Estimate your 2027 household income, including your spouse's wages and your net self-employment income.
- Check the 10.22% test for family coverage.
- Compare total costs: the job-based family plan versus your spouse on the job plan and the rest of the family on a Marketplace plan.
Key 2027 dates
Open Enrollment for 2027 runs Nov 1, 2026 to Jan 15, 2027. Enroll by Dec 15 for coverage that starts Jan 1; enrollments from Dec 16 to Jan 15 start Feb 1. Outside Open Enrollment, you generally need a qualifying life event, like losing coverage, moving, getting married or having a baby.
How Health Services Pro helps
Health Services Pro is a licensed, independent agency in Sunrise, Florida, licensed in 30+ states, including Florida and Texas. We work with 50+ carriers and have Spanish-speaking agents. Working with a licensed broker generally costs nothing extra, because brokers are typically paid by the carriers. See our individual and family coverage page.
Frequently asked questions
What is the family glitch fix? Since 2023, family members' job-based coverage is judged affordable based on the employee's share of the family premium, not just the cost of self-only coverage.
What is the affordability percentage for 2027? For plan years beginning in 2027, the percentage is 10.22% of household income.
Can my spouse stay on the job plan while the rest of us use the Marketplace? Yes, that's one option to compare. If family coverage through the job isn't affordable under the 10.22% test, the other family members may be able to get Marketplace help.
Does my spouse's income count? Yes. The Marketplace counts the expected income of everyone in your tax household, including a spouse's wages.
Can I still take the self-employed health insurance deduction? Not for months you were eligible for a subsidized employer plan, including through your spouse.
Get your quote
Compare 2027 plans from 50+ carriers in one call: request a quote or call (954) 736-0885.