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Self-Employed in your state and Stuck Paying High Health Insurance? Read This.
You built a business, you make good money, and your reward is the most expensive health insurance in the state. Here are the three moves that actually change the number.
Move 1: lower your MAGI, not your income
Subsidies look at modified adjusted gross income. SEP-IRA or Solo 401(k) contributions, the self-employed health deduction, and legitimate business expenses all lower MAGI. Some 1099 contractors who think they're $10,000 over the cliff are actually under it. Run the numbers with a CPA before open enrollment. If your state has an income tax, the self-employed health premium deduction lowers state taxable income too; in no-income-tax states like Texas, Tennessee and Florida it only helps federally.
Move 2: price the private market
If you're truly above the line and healthy, private shared-network plans on Cigna, Aetna and PHCS PPO are priced on your health, not your income. Expect 30–50% less than full-price marketplace plans, with a national PPO. Underwritten, so not for everyone — but for the healthy self-employed it's the biggest lever there is.
Move 3: check whether you're really "solo"
A spouse on payroll, a part-time employee, a business partner — any of these can open a small-group plan, which is guaranteed-issue and often priced better than two individual plans.
What doesn't work
Health-sharing ministries (not insurance), fixed-indemnity plans (not major medical), and simply going without. A few states (New Jersey, California, Massachusetts, Rhode Island, DC) have their own individual mandate; most don't.
Fifteen minutes with a licensed agent who quotes both markets usually finds one of the three. Start here.