What the ACA requires of employers
- Who's covered by the rule: an applicable large employer (ALE) has at least 50 full-time employees, including full-time equivalents, on average during the prior year. Part-time hours count toward that total.
- Who must be offered coverage: full-time employees, meaning an average of at least 30 hours of service a week or 130 a month, and their dependent children under 26.
- The 95% test: an ALE that doesn't offer coverage to at least 95% of full-time employees may owe a payment if even one full-time employee gets a premium tax credit.
- Part-time workers: the IRS says an ALE need not offer coverage to part-time employees to avoid a payment. Employers can still choose to.
Employers with fewer than 50 full-time employees and equivalents aren't subject to this rule. Some offer coverage anyway.
If your hours change
Employers can use a look-back period to measure whether variable-hour employees average 30 hours. If your hours go up and you're now measured as full-time at a large employer, ask HR when you'll be offered coverage. If hours drop and you lose job coverage, that's a qualifying event for COBRA and for a 60-day Marketplace Special Enrollment Period. See health insurance between jobs.
Marketplace and Medicaid for part-time workers
HealthCare.gov says if your employer doesn't offer you coverage, you can apply through the Marketplace and find out whether you qualify for savings on premiums and out-of-pocket costs. You may also qualify for free or low-cost coverage through Medicaid or CHIP.
| Your situation | Marketplace savings? |
|---|---|
| Job offers you no coverage | Possibly, based on household income and size |
| Job offers coverage that's affordable and meets minimum standards | No, though you can still buy a plan at full price |
| Job offers coverage that isn't considered affordable or doesn't meet minimum value | Possibly |
| Enrolled in a job plan | No |
Open Enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027 on HealthCare.gov. State exchanges can set different dates.
Where Gabriel fits
Gabriel can quote Marketplace plans for your ZIP code and household, show the price after any tax credit, and open your own application with a licensed agent in most states. You choose the plan and finish the application.
Gabriel is a membership, not health insurance, and Gabriel is not an insurer. It does not replace a health plan's protection against large medical bills.
Common questions
How many hours do you have to work to get health insurance?
Under the ACA, large employers must offer coverage to employees averaging 30 or more hours a week (130 a month). Employers can set a lower threshold if they choose.
Do part-time employees get health insurance?
Only if the employer chooses to offer it. Federal law doesn't require it. Part-time workers without an offer can use the Marketplace.
Can I get a Marketplace subsidy if I work part time?
Yes, if your job doesn't offer affordable coverage that meets minimum standards and your household income is in the eligible range.
Can I get Medicaid while working part time?
Possibly. Medicaid is based on income, not hours. In expansion states, adults below 138% of the federal poverty level may qualify.
Do small businesses have to offer health insurance?
No. The ACA employer requirement applies to employers with 50 or more full-time employees, including full-time equivalents.
Sources
- Identifying full-time employees IRS
- Determining if an employer is an applicable large employer IRS
- Questions and answers on employer shared responsibility provisions IRS
- Health coverage for part-time workers HealthCare.gov
- If you have job-based coverage HealthCare.gov
- Federal poverty level (FPL) HealthCare.gov
- Questions and answers on the Premium Tax Credit IRS
- COBRA continuation coverage U.S. Department of Labor
This guide is general information, not medical advice. It does not replace a visit with a licensed clinician. Gabriel membership is not health insurance.