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The federal poverty level (FPL) is commonly used to refer to the federal poverty guidelines that HHS issues each year. (Although HHS notes that “federal poverty guidelines” is actually the correct terminology, and that “federal poverty level” should be avoided, the latter tends to be more frequently used.)
It’s specified as an income amount that is used to determine eligibility for various income-based public programs, such as Medicaid, premium tax credits, and cost-sharing reductions. The specific dollar amount varies based on the number of people in the household and whether the household is in Alaska, Hawaii, or the continental U.S.
The federal poverty level is used to determine eligibility for Medicaid and CHIP (the Children's Health Insurance Program); to determine eligibility for ACA premium tax credits and cost-sharing reductions (subsidies); and eligibility for Medicare Savings Programs (MSPs) and the Low-Income Subsidy for Medicare Part D.
The federal poverty guidelines are set each year by the Department of Health and Human Services (as opposed to the poverty threshold, which is set by the Census Bureau and used for statistical purposes rather than for the administration of income-based federal programs).
The federal poverty level is higher in Alaska and Hawaii. HHS sets three different amounts each year: One for the continental United States, a higher level for Hawaii, and an even higher level for Alaska. But within the continental U.S., the federal poverty level does not vary.
HHS publishes updated federal poverty level numbers in mid-January each year. This new amount starts to be used soon thereafter (no later than April 1) for determining eligibility for Medicaid and CHIP. But the prior year’s federal poverty level numbers continue to be used to determine eligibility for premium tax credits and cost-sharing reductions until open enrollment starts again in the fall.
So for example, if a person applies for Medicaid in April 2023, their current household income would be compared with the 2023 federal poverty level amount. But if they qualify for a special enrollment period and apply for an individual market plan through the marketplace, the marketplace will compare their total projected 2023 household income (including what they’ve already earned in 2023 and what they expect to earn for the rest of the year) with the 2022 federal poverty level amount for their household size.
Medicaid and CHIP eligibility are checked first when a person applies for a plan in the marketplace. If a person is eligible for Medicaid or CHIP, they are not eligible for premium subsidies for a marketplace plan. But assuming they’re not eligible for Medicaid or CHIP, the marketplace will then determine whether they’re eligible for premium subsidies, and if so, how much the subsidy will be.
The 2022 poverty level numbers were published on January 12, 2022, and are used to determine subsidy eligibility for 2023 coverage. For a single person, the 2022 federal poverty level is $13,590 in the continental U.S. For each additional person in the household, the federal poverty level increased by $4,720 (so for a household of three, for example, the 2022 federal poverty level is $23,030).
These numbers began to be used to determine Medicaid and CHIP eligibility by the spring of 2022. But they didn’t start to be used to determine subsidy eligibility for plans in the marketplace/exchange until open enrollment for 2023 coverage began in November 2022.
The poverty level numbers are higher in Alaska and Hawaii than they are in the rest of the U.S. Both Alaska and Hawaii have expanded Medicaid under the ACA, so Medicaid is available to adults under the age of 65 if their household income doesn’t exceed 138% of the federal poverty level. Premium subsidy eligibility in both states starts above 138% of the poverty level, which is a different dollar amount in Alaska and Hawaii, since they have different federal poverty levels.
The 2022 federal poverty level for a single person in Hawaii is $15,630, with an increase of $5,430 for each additional member of the household. And for a single person living in Alaska, it’s $16,990, with an increase of $5,900 for each additional person in the household. These numbers are used to determine subsidy eligibility for 2023 coverage, and Medicaid/CHIP eligibility until the states transition to the new 2023 numbers in early 2023.
You can see the 2022 and 2023 federal poverty levels below, with amounts based on family size and location. (The 2022 poverty level numbers are still used to determine subsidy eligibility for people who are enrolling in 2023 coverage due to a qualifying life event such as losing other coverage, getting married, or having a baby; the 2023 numbers will be used for Medicaid/CHIP eligibility determinations starting in early 2023 — no later than April 1 — and for marketplace subsidy eligibility starting November 1, 2023, when people are enrolling in 2024 coverage).
2022 Federal Poverty Guidelines | |||
---|---|---|---|
Persons in family / household | 48 contiguous states and DC | Alaska | Hawaii |
1 | $13,590 | $16,990 | $15,630 |
2 | $18,310 | $22,890 | $21,060 |
3 | $23,030 | $28,790 | $26,490 |
4 | $27,750 | $34,690 | $31,920 |
5 | $32,470 | $40,590 | $37,350 |
6 | $37,190 | $46,490 | $42,780 |
7 | $41,910 | $52,390 | $48,210 |
8 | $46,630 | $58,290 | $53,640 |
9+ | If more than 8 in household / family, add $4,720 per additional person. | If more than 8 in household / family, add $5,900 per additional person. | If more than 8 in household / family, add $5,430 per additional person. |
2023 Federal Poverty Guidelines | |||
---|---|---|---|
Persons in family / household | 48 contiguous states and DC | Alaska | Hawaii |
1 | $14,580 | $18,210 | $16,770 |
2 | $19,720 | $24,640 | $22,680 |
3 | $24,860 | $31,070 | $28,590 |
4 | $30,000 | $37,500 | $34,500 |
5 | $35,140 | $43,930 | $40,410 |
6 | $40,280 | $50,360 | $46,320 |
7 | $45,420 | $56,790 | $52,230 |
8 | $50,560 | $63,220 | $58,140 |
9+ | If more than 8 in household / family, add $5,140 per additional person. | If more than 8 in household / family, add $6,430 per additional person. | If more than 8 in household / family, add $5,910 per additional person. |
The federal poverty thresholds were first introduced in 1965, based on the work of the Social Security Administration’s Mollie Orshansky. The amounts were tied to the bare minimum amount that people needed in order to have adequate food, with a multiplier used to account for other necessary expenses. Orshansky noted at the time that the poverty thresholds were a measure of the amount of income that would be inadequate for people to live, as opposed to a minimum adequate amount.
By the late 1960s, the federal poverty guidelines began to be indexed based on the Consumer Price Index. And other changes have been made over the years as well, such as eliminating the separate poverty level guidelines for farm families in the early 1980s.
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