Federal Poverty Level (FPL)

The Federal Poverty Level (FPL) is updated each January by the Department of Health and Human Services (HHS). It varies by household size and geographic location (48 contiguous states, Alaska, and Hawaii have separate tables). For ACA marketplace purposes, your income as a percentage of FPL determines both eligibility and the size of your premium tax credit. The key thresholds are: below 100% FPL (generally no subsidy in non-expansion states), 100-138% FPL (Medicaid eligible in expansion states), 138-400% FPL (subsidy eligible on marketplace), and above 400% FPL (no subsidy, the "cliff"). For 2026, each additional household member adds $5,680 to the FPL threshold.

Example

A family of four has a 2026 FPL of $33,000. If the family earns $90,000, they are at 272.7% FPL ($90,000 / $33,000). This places them in the 250-300% bracket with an applicable percentage around 9.1%, qualifying for a subsidy. At $133,000 (403% FPL), they would be above the 400% cliff and receive no subsidy.

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Health Insurance Cost Estimation

Health insurance costs most Americans between $200 and $1,800 per month depending on age, location, income, and coverage type. The Affordable Care Act (ACA) marketplace provides subsidies (premium tax credits) that reduce costs for people earning between 100% and 400% of the Federal Poverty Level (FPL). For 2026, the subsidy formula is: Premium Tax Credit = Second Lowest Cost Silver Plan premium minus (your income times your applicable percentage, which ranges from 2.1% to 9.96%). Employer-provided coverage averages $9,325/year for single plans, with employers paying roughly 79% of the cost.