What Is Medicaid Expansion?
The Affordable Care Act gave states the option to expand Medicaid eligibility to all adults earning up to 138% of the Federal Poverty Level (approximately $21,597/year for a single adult in 2026). The federal government covers 90% of the cost of expansion. States that chose to expand are called "expansion states."
Expansion States (as of 2026)
The following states (plus Washington, D.C.) have expanded Medicaid. Adults earning up to 138% FPL may qualify for free or low-cost Medicaid in these states:
Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee (pending), Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin (partial), Wyoming (pending)
Non-Expansion States (as of 2026)
The following states have not expanded Medicaid as of 2026. Adults without children or disabilities face very low income limits (often $9,000–$10,000/year or less) to qualify:
- Florida — Voters passed Amendment 2 in 2024; implementation pending legislative action
- Texas — Largest non-expansion state by population
- Georgia — Limited expansion approved for some working adults only
- Alabama
- South Carolina
- Kansas
What This Means for Low-Income Adults
In expansion states, adults earning 100%–138% FPL have a choice: Medicaid (free) or marketplace plan (subsidized). Medicaid is almost always the better value at that income level — $0 premium, $0 deductible, minimal or no copays.
In non-expansion states, adults in that income range may fall into a "coverage gap": too high for state Medicaid, too low for marketplace subsidies (which begin at 100% FPL). If you are in this range in a non-expansion state, contact a licensed broker or your state's Medicaid office to confirm your options.
Wisconsin: The Special Case
Wisconsin has not formally adopted ACA expansion but covers adults up to 100% FPL through BadgerCare Plus — meaning there is no coverage gap for adults below the poverty line, but adults between 100% and 138% FPL go to the marketplace rather than Medicaid.