Understanding ACA Health Insurance and Federal Poverty Level (FPL) in 2025
- Geri Reynolds
- Mar 31
- 3 min read
In the landscape of U.S. healthcare, the Affordable Care Act (ACA) continues to be a transformative force, striving to make quality health insurance more accessible and affordable for millions of Americans. A key component of this system is the Federal Poverty Level (FPL) — a critical benchmark used to determine eligibility for financial assistance programs like subsidies and Medicaid.
Let’s break down what ACA health insurance involves in 2025, the importance of Federal Poverty Level (FPL) numbers, and how they influence your coverage options and costs.
What Is ACA Health Insurance?
Originally enacted in 2010, the ACA brought sweeping reforms to the healthcare system. One of its most impactful changes was the creation of health insurance marketplaces — platforms where individuals and families can compare and purchase coverage plans that meet their health and financial needs.
The ACA also expanded Medicaid eligibility in participating states and introduced premium tax credits and cost-sharing reductions to help make coverage more affordable for those who qualify.
What Are Federal Poverty Level (FPL) Numbers in 2025?
The Federal Poverty Level (FPL) is a guideline set by the federal government to help determine eligibility for various assistance programs, including:
Medicaid
Children’s Health Insurance Program (CHIP)
Premium tax credits and subsidies for ACA marketplace plans
FPL numbers vary based on household size and income. Here is the breakdown of the FPL numbers in 2025:
People with household incomes between 100% and 400% of the FPL are typically eligible for premium tax credits to reduce the cost of monthly premiums. Those with incomes below 138% of the FPL (in states that expanded Medicaid) may qualify for Medicaid coverage.
Important Note: Many people assume that if they earn more than 400% of the FPL, they don’t qualify for subsidies. However, since the American Rescue Plan and Inflation Reduction Act extended enhanced subsidies, many individuals above that threshold can still receive tax credits — especially if their insurance premiums exceed a certain percentage of their income. It’s always best to consult with a licensed insurance agent to ensure you’re receiving every subsidy and discount you’re entitled to.
How FPL Affects Your Coverage and Costs
FPL numbers directly influence how much assistance you can receive. This structure allows the ACA to target help to those who need it most, increasing health coverage accessibility for individuals and families facing financial challenges. Subsidies based on FPL can often be the difference between affordable care and going without coverage.
When to Enroll in Coverage
Enrollment through the ACA marketplace is available during the annual Open Enrollment Period — typically November 1 to January 15 each year. However, if you experience a Qualifying Life Event (such as marriage, the birth of a child, a move, or loss of other coverage), you may be eligible for a Special Enrollment Period (SEP).
Get Personalized Help from Lion’s Pride Insurance
Navigating health insurance options can be confusing — but you don’t have to do it alone. The knowledgeable agents at Lion’s Pride Insurance are ready to help you:
Understand your eligibility
Explore plan options
Maximize your savings through subsidies
Enroll with confidence
Whether you’re new to ACA insurance or reviewing your current coverage for 2025, their team is here to simplify the process.
Have questions about your income and ACA Marketplace eligibility?
Call Lion’s Pride Insurance today at (801) 896-8377.
We're ready to help you get the coverage you need.
If you would like to review the Federal Poverty Limits (FPL) for 2024, click below.
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