Published: June 23, 2026.
FPL is the federal poverty level. HHS publishes annual dollar amounts by household size. ACA subsidy eligibility, CSR tiers, and Medicaid expansion thresholds are expressed as percentages of FPL.
Key Takeaways
- FPL is the federal poverty level. HHS publishes annual dollar amounts by household size. ACA subsidy eligibility, CSR tiers, and Medicaid expansion thresholds are expressed as percentages of FPL.
- For APTC, households generally need income between 100 and 400 percent FPL in non expansion states, with Medicaid covering many below 138 percent FPL in expansion states. CSR applies between 100 and 250 percent FPL on Silver plans.
- The 400 percent FPL subsidy cliff was softened by federal law that caps the household contribution at 8.5 percent of income for Marketplace coverage. Brokers should still run live eligibility math rather than relying on pre 2021 rules of thumb.
- FPL tables update each plan year. Brokers quoting in October for January coverage should confirm the new year's poverty guidelines before finalizing subsidy estimates.
For APTC, households generally need income between 100 and 400 percent FPL in non expansion states, with Medicaid covering many below 138 percent FPL in expansion states. CSR applies between 100 and 250 percent FPL on Silver plans.
The 400 percent FPL subsidy cliff was softened by federal law that caps the household contribution at 8.5 percent of income for Marketplace coverage. Brokers should still run live eligibility math rather than relying on pre 2021 rules of thumb.
FPL tables update each plan year. Brokers quoting in October for January coverage should confirm the new year's poverty guidelines before finalizing subsidy estimates.
Related field notes
- Do I qualify for an ACA subsidy? 2026 income limits and eligibility
- The ACA subsidy cliff: how it changed and what to tell clients now
- The ACA coverage gap: what brokers in non-expansion states need to know
Related glossary terms
FAQ
Common broker questions about this term.
Who publishes the federal poverty guidelines?
The HHS Assistant Secretary for Planning and Evaluation publishes updated guidelines each year, typically in January for the coverage year.
Is FPL the same in every state?
The base FPL dollar amounts are federal. States may use different FPL percentages for Medicaid and CHIP programs, but Marketplace APTC and CSR use the federal guidelines.
How do brokers convert client income to FPL percentage?
Divide household MAGI by the HHS poverty guideline for the household size, then multiply by 100. QuoteTurbo runs this calculation inline during quoting.
