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Are There Better Health Insurance Options for Freelancers in your state?

By Martin Elefant · Licensed insurance agent · Updated October 2026 · 5 min read

Freelancers in your state — designers, writers, developers, photographers, musicians — usually buy whatever HealthCare.gov shows them in November and move on. There's often a better fit.

If your income is modest or variable

The marketplace is probably right, and you may qualify for a larger subsidy than you think once expenses are deducted. Medicaid expansion varies by state — in non-expansion states such as Texas, Georgia, Tennessee, South Carolina and Florida, adults under the poverty line can fall into a coverage gap.

If you've grown past the subsidy line

Successful freelancers hit the 400% cliff and suddenly pay full price. If you're healthy, a private shared-network PPO on Cigna, Aetna and PHCS PPO is priced on your health, not your 1099s — usually 30–50% less, with a national network that travels with you.

If you work across state lines

Marketplace HMOs are local. A national PPO covers you in-network in every state, which matters for freelancers who split time between and somewhere else.

If you have a pre-existing condition

Stay on the marketplace. Private plans underwrite; the marketplace doesn't.

The national picture

Rules, carriers and prices vary by state — pick your state on our quoter to see exactly what's available where you live. 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.

Check your options — we'll show you both.

ME
Martin Elefant
Licensed insurance agent · NPN 20765405 · Lyons Life LLC · Self-Employed Private Health

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