People who don’t have health insurance from work can buy health coverage under the Affordable Care Act (ACA), also known as Obamacare. The premiums are made affordable by a premium subsidy in the form of a tax credit calculated off of your income relative to the Federal Poverty Levels (FPL), also known as the HHS poverty guidelines.
The Maximum Income
Before 2021, you qualified for the premium subsidy only if your modified adjusted gross income (MAGI) was at 400% FPL or below. If your MAGI went above 400% FPL even by $1, you lost all the subsidy.
Changes in the law turned the cliff into a gradual slope through 2025. You still qualify for a premium subsidy now if your income is over 400% FPL. You just qualify for a lower amount as your income goes up. See ACA Premium Subsidy Cliff Turns Into a Slope. The cliff is scheduled to return in 2026.
Modified Adjusted Gross Income for the ACA premium subsidy is basically your adjusted gross income (AGI) plus tax-exempt muni bond interest, plus untaxed Social Security benefits. In order to see how much you qualify for the premium subsidy, you have to know where the FPL is.
The Minimum Income
In addition to the maximum income to receive the premium subsidy, there is also a minimum income to be accepted by the ACA marketplace. If your estimated income is too low, the ACA marketplace won’t accept you. They send you to Medicaid instead. The minimum income is 138% FPL in states that expanded Medicaid. In states that didn’t expand Medicaid, the minimum income is 100% FPL. Here’s a map from the Kaiser Family Foundation that shows which states expanded Medicaid and which states did not: Current Status of State Medicaid Expansion Decisions.
However, unlike the maximum income, the minimum income is only evaluated at the time of enrollment, not at the time when you file your tax return. If your estimated income at the time of enrollment is below the minimum, the ACA marketplace won’t accept you, and they will refer you to Medicaid. If your estimated income at the time of enrollment is above the minimum and they accepted you, but your income for the year ended up below the minimum due to unforeseen circumstances, as long as you made the original estimate in good faith, you are not required to pay back the premium subsidy you already received.
The FPL Numbers
Here are the numbers for coverage in 2022, 2023, and 2024. They increase with inflation every year in January. These are applied with a one-year lag. Your eligibility for a premium subsidy for 2023 is based on the FPL numbers announced in 2022. The new numbers announced in 2023 will be used for coverage in 2024.
There are three sets of numbers. FPLs are higher in Alaska and Hawaii than in the lower 48 states and Washington DC.
48 Contiguous States and Washington DC
| Number of persons in household | 2022 coverage | 2023 coverage | 2024 coverage |
|---|---|---|---|
| 1 | $12,880 | $13,880 | $14,580 |
| 2 | $17,420 | $18,310 | $19,720 |
| 3 | $21,960 | $23,030 | $24,860 |
| 4 | $26,500 | $27,750 | $30,000 |
| 5 | $31,040 | $32,470 | $35,140 |
| 6 | $35,580 | $37,190 | $40,280 |
| 7 | $40,120 | $41,910 | $45,420 |
| 8 | $44,660 | $46,630 | $50,560 |
| amuse | add $4,540 each | add $4,720 each | add $5,140 each |
Alaska
| Number of persons in household | 2022 coverage | 2023 coverage | 2024 coverage |
|---|---|---|---|
| 1 | $16,090 | $16,990 | $18,210 |
| 2 | $21,770 | $22,890 | $24,640 |
| 3 | $27,450 | $28,790 | $31,070 |
| 4 | $33,130 | $34,690 | $37,500 |
| 5 | $38,810 | $40,590 | $43,930 |
| 6 | $44,490 | $46,490 | $50,360 |
| 7 | $50,170 | $52,390 | $56,790 |
| 8 | $55,850 | $58,290 | $63,220 |
| amuse | add $5,680 each | add $5,900 each | add $6,430 each |
Hawaii
| Number of persons in household | 2022 coverage | 2023 coverage | 2024 coverage |
|---|---|---|---|
| 1 | $14,820 | $15,630 | $16,770 |
| 2 | $20,040 | $21,060 | $22,680 |
| 3 | $25,260 | $26,490 | $28,590 |
| 4 | $30,480 | $31,920 | $34,500 |
| 5 | $35,700 | $37,350 | $40,410 |
| 6 | $40,920 | $42,780 | $46,320 |
| 7 | $46,140 | $48,210 | $52,230 |
| 8 | $51,360 | $53,640 | $58,140 |
| amuse | add $5,220 each | add $5,430 each | add $5,910 each |
Source:
The Applicable Percentages
The FPL numbers determine one aspect of your eligibility for the premium subsidy. How much you are expected to pay when you qualify for the premium subsidy is also determined by a sliding scale called the Applicable Percentages. We cover it in ACA Health Insurance Premium Tax Credit Percentages.
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