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Glossary

Federal Poverty Level (FPL)

An income threshold set by the federal government that determines eligibility for Marketplace subsidies, Medicaid, and many other safety-net programs. Updated annually and varies by household size.

Last updated: May 18, 2026

The Federal Poverty Level (FPL) — sometimes called the “federal poverty guidelines” — is an income standard issued each year by the Department of Health and Human Services. For ACA eligibility, the FPL number determines whether you qualify for APTC, CSR, or Medicaid, and how much subsidy you receive.

2025 FPL (used for 2026 ACA coverage)

The ACA Marketplace uses the prior year’s FPL when determining eligibility — so for 2026 coverage purchased during OEP 2026, the 2025 FPL is the reference.

Household size100% FPL (2025, 48 contiguous states + DC)400% FPL
1$15,650$62,600
2$21,150$84,600
3$26,650$106,600
4$32,150$128,600
5$37,650$150,600
6$43,150$172,600

For households larger than 6, add $5,500 per additional person to the 100% number, $22,000 to the 400% number. Alaska and Hawaii use higher FPL tables (Alaska is ~25% higher, Hawaii ~15% higher).

Why the percentages matter

ACA programs gate eligibility on percentages of FPL:

% of FPLWhat it unlocks
0% – 138%Medicaid (in expansion states; in non-expansion states, the cutoff is around 100%)
100% – 150%Highest APTC subsidy + best CSR (94% AV)
150% – 200%Strong APTC + CSR 87% AV
200% – 250%APTC + reduced CSR 73% AV
250% – 400%APTC on sliding scale, no CSR
Above 400%No APTC for 2026 (the “subsidy cliff” returned post-IRA expiration)

The non-expansion state gap

In states that did not expand Medicaid under the ACA (Florida, Texas, Georgia, Mississippi, Alabama, Tennessee, South Carolina, Wyoming, Kansas, Wisconsin), there is a “coverage gap” for adults earning under 100% FPL. They are too poor for Marketplace subsidies (which only start at 100%) but not eligible for Medicaid. This affects roughly 1.5 million people, disproportionately Hispanic and Black. Children in these states still qualify for CHIP.

How to use FPL to estimate your subsidy

Example: family of 3 in Texas with $40,000 household income.

  • 100% FPL for 3 people: $26,650
  • $40,000 / $26,650 = 1.50 = 150% FPL

At 150% FPL, this family is in the highest-subsidy band and the best CSR tier. The calculator takes this and combines with the benchmark Silver plan price for their county to give exact APTC + CSR.

What changed for 2026

The Inflation Reduction Act’s enhanced subsidies (which removed the 400% cliff and added subsidies up the income scale) expired December 31, 2025. For 2026 coverage:

  • The 400% cliff is back — above 400% FPL, no APTC.
  • The applicable-percentage schedule shifted back to IRS Rev. Proc. 2025-25 (2.10–9.96%).
  • Lower-income families (below 250% FPL) still see substantial subsidies because the % they are expected to contribute is small.

Use the calculator with your income to see your FPL % and estimated subsidy.

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