What are the 2026 federal poverty level thresholds used to determine ACA premium tax credit eligibility?
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
The 2026 ACA premium tax credit eligibility hinges on the federal poverty guidelines for 2026 (used to compare projected 2026 income against the relevant FPL) and the related ACA affordability safe-harbor numbers — notably a single-person FPL of $15,650, which produces a federal-poverty-line safe-harbor monthly employee contribution of about $129.89–$129.90 (9.96% of monthly FPL) [1] [2]. Reporting and guidance note that marketplaces compare projected coverage‑year income to the prior year’s published poverty guidelines and that some outlets cite differing per‑person add‑ons for households over eight (either $5,380 or $5,500), reflecting inconsistent secondary reporting of the official HHS/FR notice [3] [4] [5].
1. What number actually determines subsidy eligibility — the year and the guideline
Eligibility for premium tax credits for a 2026 coverage year is determined by comparing the household’s projected 2026 MAGI to the applicable federal poverty guideline published for 2026 (the coverage‑year FPL). Several consumer‑facing explainers explicitly state that coverage‑year eligibility is evaluated against the FPL for that coverage year [6] [5]. Note: some employer affordability guidance references using the 2025 guideline for employers with certain plan‑year timing, but subsidy eligibility for individuals uses the 2026 guideline for 2026 coverage [6] [7].
2. The headline FPL figures cited by reporting
Multiple practical guidance pieces and adviser blogs use a single‑person 2026 FPL of $15,650. That figure is used to calculate the FPL safe‑harbor affordability monthly threshold: $15,650 ÷ 12 × 9.96% = roughly $129.89–$129.90 per month [1] [2]. Employer‑oriented pieces repeat the 9.96% affordability percentage for 2026 (up from 9.02% in 2025) and show that amount as the benchmark for the employer mandate safe harbor and as an input in subsidy/affordability considerations [8] [1].
3. Conflicting reporting on per‑person increases for large households
Secondary sources disagree about the per‑person increment for households larger than eight when constructing the 100% FPL figure. One reference cites adding $5,380 per additional person (quoting a Federal Register ASPE reference), while another cites $5,500 per additional person — both appear in practitioner or aggregator materials and reflect inconsistent echoing of the official table [3] [4]. Available sources do not present the original HHS Federal Register table itself in our set; therefore, the exact official add‑on cannot be confirmed here (not found in current reporting).
4. How the affordability safe‑harbor ties into subsidies and employer obligations
For employers and consumers, the same FPL numbers underlie affordability calculations. The IRS issued an affordability percentage of 9.96% for plan years beginning in 2026; when employers use the Federal Poverty Line safe harbor, they test whether the employee‑only premium is at or below roughly $129.89/month (derived from the single‑person FPL of $15,650) to deem coverage affordable [1] [2]. Advisers warn employers to pick the appropriate safe harbor (FPL, rate‑of‑pay, or W‑2) based on plan timing and available data [8] [7].
5. Practical takeaways for marketplace consumers
Individuals shopping the Marketplace for 2026 coverage should compare projected 2026 income to the 2026 poverty guidelines to determine premium tax credit eligibility; many consumer guides and calculators reference that relationship and indicate that changes in FPL and the 9.96% threshold will affect subsidy amounts [5] [6]. States that use Medicaid expansion rules still route very low incomes toward Medicaid rather than Marketplace subsidies, and the minimum income rules applied at enrollment can shift applicants between Medicaid and Marketplace pathways [4] [6].
6. Sources, gaps and why secondary outlets disagree
The materials provided are a patchwork of IRS, employer‑adviser, and consumer‑facing writeups, not the primary HHS/ASPE Federal Register table; this produces discrepancies such as the $5,380 vs. $5,500 per‑person add‑ons and timing notes about which year’s guideline employers may use for different plan years [3] [4] [7]. Reporters and analysts should consult the official HHS/ASPE poverty guidelines and the Federal Register affordability notice for definitive per‑household amounts; available sources here repeat those numbers but do not include the original HHS table in full for direct citation (not found in current reporting).
If you want, I can pull the official HHS/ASPE 2026 poverty guideline table and the Federal Register affordability notice for direct confirmation of the per‑person increments and the formal HHS wording.