DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
 
 
CMCS Informational Bulletin  
 
DATE:   February 9, 2016 
    
FROM:   Vikki Wachino  
Director 
Center for Medicaid and CHIP Services 
 
SUBJECT:   2016 Federal Poverty Level Standards  
 
As required by Section 673(2) of the Omnibus Budget Reconciliation Act (OBRA) of 1981 (42 U.S.C. 
9902(2)), the Department of Health and Human Services (HHS) updates the poverty guidelines at least 
annually and by law these updates are applied to eligibility criteria for programs such as Medicaid and the 
Childrens Health Insurance Program (CHIP). These annual updates increase the Census Bureaus current 
official poverty thresholds by the relevant percentage change in the Consumer Price Index for All Urban 
Consumers (CPIU).  
 
The 2016 guidelines reflect a 0.1 percent price increase between calendar years 2014 and 2015. After this 
inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between 
family and household sizes. In rare circumstances, the rounding and standardizing adjustments in the 
formula result in reductions to the guidelines from the previous year for some household sizes even when 
the inflation factor is not negative.  In order to prevent a reduction in the guidelines in these rare 
circumstances, beginning this year, in cases where the year-to-year change in inflation is not negative but 
the rounding and standardizing adjustments in the formula result in reductions to the guidelines from the 
previous year for some household sizes, the guidelines for the affected household sizes are fixed at the 
prior years guidelines. For 2016, the guidelines for a household size of seven or greater will remain fixed 
at 2015s guidelines for all states and the District of Columbia.  
 
For a family or household of 4 persons living in one of the 48 contiguous states or the District of 
Columbia, the poverty guideline for 2016 is $24,300. Separate poverty guideline figures are developed for 
Alaska and Hawaii, and different guidelines may apply to the Territories. The guidelines can be found at 
https://www.federalregister.gov/articles/2016/01/25/2016-01450/annual-update-of-the-hhs-poverty-
guidelines.  
 
To determine eligibility for Medicaid, CHIP, and advance payments of the premium tax credit (APTC) 
and cost-sharing reductions (CSR) for the purchase of health coverage through the Marketplace, states 
and the federal government generally use a percentage multiple of the guidelines (for example, 133 
percent or 185 percent of the guidelines). The Federally-facilitated Marketplace (FFM) will begin using 
the 2016 FPLs for Medicaid and CHIP eligibility on March 4, 2016. In accordance with section 36B of 
the Internal Revenue Code, eligibility for APTC and CSR will continue to be determined using 2015 
FPLs for all APTC and CSR for enrollment that is effective in 2016.  
 
Included with this informational bulletin is the 2016 Dual Eligible Standards chart that displays the new 
standards for the Medicare Savings Program categories. These standards are also available on 
Medicaid.gov at https://www.medicaid.gov/medicaid-chip-program-information/by-population/medicare-
medicaid-enrollees-dual-eligibles/seniors-and-medicare-and-medicaid-enrollees.html.   CMCS Informational Bulletin  Page 2 
 
Please update your standards in accordance with this information. If you have any questions or need 
additional information, please contact Judith Cash at 410-786-4473 or Judith.Cash@cms.hhs.gov.