Medicaid Expansion by State: What It Means for You

What is Medicaid expansion?

Medicaid is free or low-cost health coverage run by each state with federal funding. In 2014, states got the option to expand Medicaid to cover more people. Some states said yes. Others said no. That decision shapes who can get Medicaid today.

States that expanded Medicaid opened coverage to more adults. States that did not expand keep stricter income limits. This means a person with the same income might qualify in one state but not another.

Income limits in expansion states

In states that expanded Medicaid, most adults aged 19–64 qualify with income up to 138% of the federal poverty level (133% plus a standard 5% income disregard).

For 2026, the federal poverty guideline in most states is:

• $15,960 a year for 1 person
• $21,640 for 2 people
• $27,320 for 3 people
• $33,000 for 4 people

Alaska and Hawaii have higher guidelines. So 138% of the poverty level varies by state and by household size.

Example: In an expansion state in 2026, a single person earning about $22,025 a year could qualify (138% of $15,960). A family of four earning about $45,540 could qualify (138% of $33,000).

Who else Medicaid covers

Medicaid also covers children, pregnant people, older adults and people with disabilities. Income limits differ by group and by state. Some groups may qualify even if they earn more than the adult limit.

Income limits in non-expansion states

States that did not expand Medicaid keep lower income limits. Usually these limits apply only to parents, children, pregnant people, older adults and people with disabilities—not to other adults. In many non-expansion states, a childless adult with almost any income does not qualify for Medicaid.

If you live in a non-expansion state, check your state's Medicaid rules. The state may have other programs or pathways to coverage.

How to find your state's rules

The state income levels vary widely. To find the exact limits in your state, go to our Medicaid page and select your state. You can also visit Medicaid.gov and choose your state.

Note: State income levels come from Medicaid.gov and reflect state decisions as of December 1, 2023.

How to apply

You can apply for Medicaid at any time of year. Apply through your state Medicaid agency or through HealthCare.gov, which sends the application to your state.

Applying is free. Only the state Medicaid agency decides if you qualify based on income, household size and other factors.

Check if you might qualify

Not sure if you qualify? Use our free screening tool to get started. It asks a few questions and shows what programs you might be eligible for in your state.