What are the federal poverty level thresholds used to set Medicaid income limits in 2024–2026?
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
The federal poverty guidelines that set the dollar thresholds states use to calculate Medicaid income limits were updated for 2024 and again for 2025; HHS published the 2024 guidelines (example: $15,060 for a single person and $31,200 for a household of two in the 48 contiguous states) and published 2025 guidelines that are used for coverage year 2026 determinations [1] [2] [3]. States apply these HHS poverty guidelines as percentages (commonly 100%, 138%, 150%, 185% and others) when setting Medicaid/CHIP and related program eligibility, and specific dollar cutoffs therefore vary by program, population group and state [2] [4] [5].
1. What the HHS “poverty guidelines” are and how they feed Medicaid rules
The HHS poverty guidelines — often called the federal poverty level (FPL) in policy shorthand — are annual, simplified dollar thresholds the Department of Health and Human Services issues to be used by entitlement and means‑tested programs; HHS updates them to reflect CPI‑U price changes and publishes them in the Federal Register each January [2] [6]. Medicaid and CHIP routinely use those guidelines as the numerator for percent‑of‑FPL rules (for example, 138% of the 2024 guideline is widely used for Medicaid expansion adults), but the guidelines themselves are just the baseline numbers; programs pick the percent and round according to their own rules [2] [4].
2. The headline numbers for 2024 and the role they played
HHS released the 2024 poverty guidelines in January 2024. For the 48 contiguous states and D.C., the 2024 guideline for a one‑person household was $15,060; HHS also published family‑size increments (for example, the guideline for three people and the two‑person amounts are in the formal tables) that states use when computing percentages for Medicaid eligibility [1] [2]. Advocacy and technical sites translated that into common program cutoffs—e.g., 138% of the 2024 individual guideline equals roughly $20,782, a commonly cited Medicaid expansion threshold [7] [8].
3. The 2025 guidelines and their use for 2026 coverage year rules
HHS published updated poverty guidelines in January 2025; those 2025 guidelines are the basis for coverage‑year 2026 determinations such as premium tax credit eligibility and other program thresholds [3] [6]. States and federal programs therefore applied the 2025 guideline figures in their 2026 coverage calculations; program rules still determine which percent of the guideline applies to a given eligibility group [3].
4. How states translate the FPL into Medicaid income limits
Medicaid income eligibility isn’t a single national dollar amount; it’s a matrix: HHS supplies the FPL table for the year and states set eligibility rules that combine a percent of FPL, household definition and income counting rules (MAGI or non‑MAGI). Common percentages used in state rules include 100% (some state programs), 138% (ACA expansion adults), 150%, 185% (children/pregnant people in some contexts) and higher percentages for pregnancy or family programs—yet each state calculates and rounds differently [2] [4] [5]. State materials and law implementers (e.g., New York’s 2025 schedule) explicitly show multiple percent‑of‑FPL cutoffs applied to different populations [5].
5. Practical implications for applicants — dollars move each year
Because HHS adjusts the guideline annually for inflation, the dollar cutoffs that result from fixed percentage rules rise automatically even if states don’t change their percent‑of‑FPL policy. That means many states saw their nominal income limits increase in 2024→2025 simply because the underlying FPL rose [7] [6]. Applicants should check the state Medicaid office for the exact monthly or annual dollar cutoff for their household size, because the federal guideline is only the starting point [2] [9].
6. Sources, disagreements and limits of available reporting
Primary federal sources — the HHS/ASPE poverty guideline tables and the Federal Register notices — are definitive for the headline FPL numbers and the methodology HHS uses to adjust them [2] [6]. State documents show how those numbers become program cutoffs (e.g., New York’s 2025 income/resource standards) but vary widely across states [5]. Available sources do not mention a single unified federal “Medicaid income limit number” for 2024–2026 because Medicaid eligibility is defined by state rules that reference the HHS guidelines at different percentages (not found in current reporting).
If you want the exact dollar limit for a particular state, program (expansion adult vs. pregnant person vs. aged/disabled) and year, tell me the state and household size and I will pull the applicable percent‑of‑FPL conversion from the cited state and HHS documents (state tables vary and must be cited to be precise) [2] [5].