2018 2019 2020 Federal Poverty Levels (FPL) For Affordable Care Act (ACA)

People who don’t have health insurance from work can buy health coverage under the Affordable Care Act, also known as Obamacare. The premiums are made affordable by a premium subsidy in the form of a tax credit calculated off your income relative to the federal poverty levels (FPL), also known as HHS poverty guidelines.

You qualify for the premium subsidy only if your modified adjusted gross income (MAGI) is at 400% FPL or below. If your MAGI goes above 400% FPL even by $1, you lose all the subsidy. See Stay Off the Obamacare ACA Premium Subsidy Cliff.

Modified Adjusted Gross Income for Obamacare is basically your gross income minus above-the-line deductions, plus tax-exempt muni bond interest, plus untaxed Social Security benefits. In order to see if you qualify for the premium subsidy, you have to know where the FPL is.

In addition to the maximum income to receive the premium subsidy, there’s also a minimum income to get 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. In 32 states plus Washington, DC that expanded Medicaid, the minimum income is 138% FPL. In states that didn’t expand Medicaid, the minimum income is 100% FPL. Here’s a map showing which states expanded Medicaid and which stated did not: Current Status of State Medicaid Expansion Decisions, Kaiser Family Foundation.

Here are the numbers for coverage in 2018, 2019, and 2020. They increase with inflation every year in January. These are applied with a one-year lag. Your eligibility for a premium subsidy for 2019 is based on the FPL number announced in 2018. The new number announced in 2019 will be used for coverage in 2020.

There are three sets of numbers. FPLs are higher in Alaska and Hawaii than in 48 contiguous states and Washington DC.

48 Contiguous States and Washington DC

Number of persons in household 2018 coverage 2019 coverage 2020 coverage
1 $12,060 $12,140 $12,490
2 $16,240 $16,460 $16,910
3 $20,420 $20,780 $21,330
4 $24,600 $25,100 $25,750
more add $4,180 each add $4,320 each add $4,420 each

Alaska

Number of persons in household 2018 coverage 2019 coverage 2020 coverage
1 $15,060 $15,180 $15,600
2 $20,290 $20,580 $21,130
3 $25,520 $25,980 $26,660
4 $30,750 $31,380 $32,190
more add $5,230 each add $5,400 each add $5,530 each

Hawaii

Number of persons in household 2018 coverage 2019 coverage 2020 coverage
1 $13,860 $13,960 $14,380
2 $18,670 $18,930 $19,460
3 $23,480 $23,900 $24,540
4 $28,290 $28,870 $29,620
more add $4,810 each add $4,970 each add $5,080 each

Source:

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2018 2019 2020 Federal Poverty Levels (FPL) For Affordable Care Act (ACA) is copyrighted material from The Finance Buff. All rights reserved.

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Author: Harry Sit

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