A first-time marketplace shopper shows how income estimates, monthly budgets and free assisters shape ACA plan choices before the Jan. 15 deadline.
Most 22-year-olds don't get excited about shopping for health insurance. DJ Mikunda does, at least a little, and he has good reason. He has been without coverage since he left home and started working in 2023, and he now manages a gas station in St. Louis. He's been treating the search as a real project, not a weekend chore.
He isn't a novice in the usual sense. He has looked at plans on healthcare.gov in past years, and the options overwhelmed him and seemed too expensive. "I feel like I'm a well-informed individual," he said. "I try to stay updated on what a deductible is and what the premiums are and copays. And I'm still finding myself a little bit lost." That gap between knowing the vocabulary and knowing how the pieces fit together is where a lot of first-time shoppers get stuck.
Start with the person who helps for free
Mikunda's sign-up path ran through an independent assister, a trained helper who doesn't sell policies. Jackie Shrago has been guiding people through the marketplace since the early days of the Affordable Care Act. If you want someone like her, healthcare.gov has a "Find local help" tool that lets you filter by ZIP code for independent assisters.
The distinction matters. Assisters are barred from charging for their work and from collecting compensation from insurance companies. Agents and brokers, by contrast, can be paid through the plans they sell. The brokers listed on healthcare.gov far outnumber the assisters, so it takes a few extra clicks to find the free option, but it's worth the effort if you want advice that isn't tied to a sale.
Your income sets the terms
Shrago didn't start with plan names. She started with income, and that's a sensible order. Whether you qualify for reduced monthly payments depends on how much you expect to earn in the coming year. The system uses a sliding scale for households below 400% of the federal poverty level. For 2027 enrollees, a single person with no children can earn up to $63,480 and still qualify for a discount.
The discount size changes quickly with income. KFF's subsidy calculator estimates that a person in their mid-20s earning $50,000 would receive an average discount of 23%. At $30,000, the tax credit would cover nearly three-quarters of the cost. Those are estimates for illustration, and your own result will depend on your details, so run the numbers with your actual projected income.
Here's the thing about that projection: it needs to be accurate. If you earn more than you estimated, you may have to pay some of the subsidy back when you file taxes. Shrago put it bluntly: "The last thing you want is a surprise when you file your income taxes." A modest, realistic income estimate tends to be safer than an optimistic one, especially for anyone with irregular hours or a new job.
Monthly cost versus what you'll actually use
Once the income picture is clear, the real trade-off appears. Shrago asked two questions: how much can you comfortably pay each month, and what kind of coverage do you truly need? Those questions pull in opposite directions. A lower premium usually means higher costs when you use care, and a richer plan usually asks more of you up front.
Mikunda's situation shows why the second question matters so much. He has a chronic joint condition that has gone largely untreated since he lost Medicaid coverage and began working. He expects to need regular doctor visits and prescription medication. For someone in that position, it can make sense to stretch the monthly budget for a plan that covers more of the medical bill. Someone who rarely sees a doctor might reasonably reach the opposite conclusion. The right balance depends on your health needs and your cash flow, and nobody else can set it for you.
Mikunda described the result as finding a "comfortable medium" between the coverage he wants and the amount he can pay. That's a good way to frame it. You're looking for a plan you can afford in a bad month, not just a good one.
Give yourself time, and start early
Shrago also encourages first-time shoppers to begin early enough to step away and think. "If you're dealing with something that is uncertain enough and you feel really awkward about it, you don't need to make a decision today," she said. "Take your time and think about it." Deciding under deadline pressure is how people end up with a plan that doesn't fit.
The timing has a practical edge, too. Assisters tend to be least available right before the marketplace's Jan. 15 deadline. If you wait until the final days, you may find your preferred helper booked solid. Reaching out in the weeks before makes it far more likely you'll get a real conversation.
Fewer helpers, more reason to plan ahead
That scheduling pressure is worth keeping in mind because the number of people available to help has shrunk. The administration cut funding for independent assisters and navigator nonprofits by roughly 90% in 2025. The Centers for Medicare & Medicaid Services said the program was inefficient, pointing to costs of more than $1,000 per person enrolled. Whatever you think of that reasoning, the practical result is fewer people doing this work. In Ohio, the number of paid navigators serving state residents dropped from 50 to five at the start of open enrollment in 2025.
For shoppers, that means the free help you can find may be thinner than it used to be. Searching your ZIP code early, contacting more than one option if the first is unavailable, and giving yourself a few weeks instead of a few days all become more important.
Mikunda's search shows what a good first pass looks like. He learned his income drives the discount, that his health needs should shape the budget, and that he doesn't have to decide on the spot. If you're in a similar spot, the next step is simple: pull together your realistic income estimate and a clear monthly number, then find a free assister before the deadline gets close.
