Medicaid Expansion by State — 2024
Under the Affordable Care Act, states can expand Medicaid to cover adults up to 138% of the Federal Poverty Level. As of 2024, 41 states and D.C. have expanded. In the 10 states that have not, adults without dependent children are often entirely ineligible for Medicaid regardless of income.
41
States expanded
10
States not expanded
138%
FPL limit in expansion states
The coverage gap in non-expansion states
Adults in non-expansion states with incomes below 100% FPL (~$15,060/year for a single person) earn too little to receive Marketplace subsidies but are also ineligible for Medicaid. This "coverage gap" affects an estimated 1.5 million adults in states like Texas, Florida, and Georgia. If you are in this situation, contact your local legal aid office or community health center for options.
| State | Status | Adult Income Limit | Notes |
|---|---|---|---|
| Alabama | ✗ Not expanded | 18% FPL (parents only) | No expansion — adults without children generally ineligible |
| Alaska | ✓ Expanded | 138% FPL | — |
| Arizona | ✓ Expanded | 138% FPL | — |
| Arkansas | ✓ Expanded | 138% FPL | — |
| California | ✓ Expanded | 138% FPL | — |
| Colorado | ✓ Expanded | 138% FPL | — |
| Connecticut | ✓ Expanded | 138% FPL | — |
| Delaware | ✓ Expanded | 138% FPL | — |
| Florida | ✗ Not expanded | ~34% FPL (parents only) | No expansion — adults without children generally ineligible |
| Georgia | ✗ Not expanded | Limited waiver (Pathways) | Partial expansion via waiver — work requirements apply |
| Hawaii | ✓ Expanded | 138% FPL | — |
| Idaho | ✓ Expanded | 138% FPL | — |
| Illinois | ✓ Expanded | 138% FPL | — |
| Indiana | ✓ Expanded | 138% FPL | HIP 2.0 — monthly contributions required above 100% FPL |
| Iowa | ✓ Expanded | 138% FPL | — |
| Kansas | ✗ Not expanded | 38% FPL (parents only) | No expansion as of 2024 — legislature has blocked multiple attempts |
| Kentucky | ✓ Expanded | 138% FPL | — |
| Louisiana | ✓ Expanded | 138% FPL | — |
| Maine | ✓ Expanded | 138% FPL | — |
| Maryland | ✓ Expanded | 138% FPL | — |
| Massachusetts | ✓ Expanded | 138% FPL | MassHealth — expanded before ACA and broader than most states |
| Michigan | ✓ Expanded | 138% FPL | Healthy Michigan Plan |
| Minnesota | ✓ Expanded | 138% FPL | MinnesotaCare available up to 200% FPL |
| Mississippi | ✗ Not expanded | 27% FPL (parents only) | No expansion — adults without children generally ineligible |
| Missouri | ✓ Expanded | 138% FPL | — |
| Montana | ✓ Expanded | 138% FPL | — |
| Nebraska | ✓ Expanded | 138% FPL | — |
| Nevada | ✓ Expanded | 138% FPL | — |
| New Hampshire | ✓ Expanded | 138% FPL | — |
| New Jersey | ✓ Expanded | 138% FPL | — |
| New Mexico | ✓ Expanded | 138% FPL | — |
| New York | ✓ Expanded | 138% FPL | Essential Plan available up to 200% FPL at $0 premium |
| North Carolina | ✓ Expanded | 138% FPL | Expanded December 2023 |
| North Dakota | ✓ Expanded | 138% FPL | — |
| Ohio | ✓ Expanded | 138% FPL | — |
| Oklahoma | ✓ Expanded | 138% FPL | Expanded July 2021 via ballot initiative |
| Oregon | ✓ Expanded | 138% FPL | — |
| Pennsylvania | ✓ Expanded | 138% FPL | — |
| Rhode Island | ✓ Expanded | 138% FPL | — |
| South Carolina | ✗ Not expanded | 67% FPL (parents only) | No expansion — adults without children generally ineligible |
| South Dakota | ✓ Expanded | 138% FPL | Expanded July 2023 via ballot initiative |
| Tennessee | ✗ Not expanded | 95% FPL (parents only) | No expansion — adults without children generally ineligible |
| Texas | ✗ Not expanded | 19% FPL (parents only) | No expansion — adults without children generally ineligible |
| Utah | ✓ Expanded | 138% FPL | — |
| Vermont | ✓ Expanded | 138% FPL | Green Mountain Care — broader than most states |
| Virginia | ✓ Expanded | 138% FPL | Expanded January 2019 |
| Washington | ✓ Expanded | 138% FPL | — |
| Washington D.C. | ✓ Expanded | 215% FPL | DC Health Alliance covers income up to 215% FPL |
| West Virginia | ✓ Expanded | 138% FPL | — |
| Wisconsin | ✗ Not expanded | 100% FPL (BadgerCare) | Not ACA expansion — BadgerCare covers adults up to 100% FPL via separate waiver |
| Wyoming | ✗ Not expanded | 58% FPL (parents only) | No expansion — adults without children generally ineligible |
18% FPL (parents only)
No expansion — adults without children generally ineligible
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
~34% FPL (parents only)
No expansion — adults without children generally ineligible
Limited waiver (Pathways)
Partial expansion via waiver — work requirements apply
138% FPL
138% FPL
138% FPL
138% FPL
38% FPL (parents only)
No expansion as of 2024 — legislature has blocked multiple attempts
138% FPL
138% FPL
138% FPL
138% FPL
27% FPL (parents only)
No expansion — adults without children generally ineligible
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
138% FPL
67% FPL (parents only)
No expansion — adults without children generally ineligible
95% FPL (parents only)
No expansion — adults without children generally ineligible
19% FPL (parents only)
No expansion — adults without children generally ineligible
138% FPL
138% FPL
138% FPL
100% FPL (BadgerCare)
Not ACA expansion — BadgerCare covers adults up to 100% FPL via separate waiver
58% FPL (parents only)
No expansion — adults without children generally ineligible
FAQ
What is 138% FPL in dollar terms for 2024?
For a single person, 138% FPL is approximately $20,783/year ($1,732/month). For a family of four, it is about $42,606/year ($3,551/month). Use our FPL Calculator for exact figures by household size.
I live in a non-expansion state. Do I have any options?
In non-expansion states, adults without children are often ineligible for Medicaid. If your income is above 100% FPL, you can apply for subsidized Marketplace coverage at healthcare.gov. If below 100% FPL, you may fall into the coverage gap. Community Health Centers (FQHCs) provide care on a sliding fee scale regardless of insurance. Some states have partial programs — check with your state's Medicaid agency.
Does expansion affect children's Medicaid eligibility?
No. Medicaid and CHIP for children is a separate eligibility track that exists in all states, regardless of expansion status. Children are covered up to 200-300% FPL in virtually all states. Only adult eligibility changes under expansion.
I moved from an expanded to a non-expanded state. Do I lose coverage?
Yes. Medicaid is administered by each state, and eligibility is determined by your state of residence. If you move to a non-expansion state where your income exceeds the local Medicaid limit, you will lose Medicaid coverage. Apply for Marketplace insurance promptly — moving states is a qualifying life event for Special Enrollment.