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Self-Employed in New York and Stuck Paying High Health Insurance? Read This.

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

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 New Yorkers who think they're $10,000 over the cliff are actually under it. Run the numbers with a CPA before open enrollment. New York (and New York City) income taxes are among the highest in the country, so the self-employed premium deduction is worth real money here.

Move 2: price the private market

If you're truly above the line and healthy, private shared-network plans on MagnaCare 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. New York has no individual mandate penalty, but it has the strictest insurance rules in the country.

Fifteen minutes with a licensed New York agent who quotes both markets usually finds one of the three. Start here.

ME
Martin Elefant
Licensed insurance agent · NPN 20765405 · Lyons Life LLC · New York Private Health

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