Which States Expanded Medicaid and What That Means for You

What Medicaid expansion means and which states have it

Medicaid expansion is a decision each state makes about whether to cover adults earning up to 138% of the federal poverty line. Not all states have chosen to expand, so your coverage options depend entirely on where you live. If you live in an expansion state, you may be covered under Medicaid as a young adult even if your parents' income is too high or you don't have a job. If you live in a non-expansion state, Medicaid for adults typically requires disability, pregnancy, or very low income — being a young adult on your own is usually not enough.

The difference matters because it changes what you actually have to do to find coverage. In expansion states, the first step is checking Medicaid income limits for adults. In non-expansion states, you'll need to look at other routes like the Affordable Care Act marketplace or your employer's plan.

Key Takeaways

• Thirty-eight states plus Washington, D.C. have expanded Medicaid to cover adults earning up to 138% of the federal poverty line; twelve states have not.
• In expansion states, you may may have access to for Medicaid as a young adult based on income alone, without needing disability or another category.
• In non-expansion states, Medicaid for young adults is usually limited to pregnancy, disability, or very low income tied to specific family situations.
• Your state's decision affects not just whether you may have access to, but also how much you'll pay for coverage through other routes.
• You can find out your state's status and income limits by contacting your state Medicaid office or using the Kaiser Family Foundation's state-by-state map.

The twelve states that have not expanded Medicaid

As of 2024, these states have not expanded Medicaid: Alabama, Florida, Georgia, Idaho, Kansas, Mississippi, Missouri, North Carolina, South Carolina, Tennessee, Texas, and Wyoming. In these states, Medicaid for adults without disability or pregnancy is extremely limited. You may still may have access to if you're pregnant, have a disability, are caring for a child, or meet very specific income thresholds that vary by state — but being a young adult earning your own income usually doesn't open the door.

If you live in one of these states, you'll need to explore the Affordable Care Act marketplace instead. You can create an account at Healthcare.gov and see what plans cost in your area. Some young adults in non-expansion states also may have access to for subsidies that lower monthly premiums, depending on income.

The thirty-eight expansion states and Washington, D.C.

The expansion states are: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and West Virginia, plus Washington, D.C.

In these states, Medicaid covers adults earning up to 138% of the federal poverty line — which in 2024 is roughly $1,738 per month for a single person, though this amount changes yearly. You don't need to be disabled, pregnant, or in a specific family situation. If your income falls below that threshold, you can contact your state Medicaid office or apply through your state's benefits portal to find out next steps.

Even if you earn slightly more than the expansion limit, you may still may have access to for a subsidy through the Affordable Care Act marketplace. The marketplace uses a different income calculation and often covers people who don't may have access to for Medicaid.

How to find out your state's status and income limits

The fastest way is to call your state Medicaid office directly. You can find the number by searching "[your state] Medicaid" or by calling 211, which connects you to local benefits information. When you call, ask whether your state has expanded Medicaid and what the current income limit is for a single adult with no dependents.

You can also visit the Kaiser Family Foundation's website, which maintains a state-by-state map showing which states have expanded and what their income limits are. This map updates as states make changes, so it's a reliable reference point. Write down your state's limit and the contact information for your state Medicaid office — you'll need both if you decide to move forward.

What happens if your state hasn't expanded but you still need coverage

Your main option is the Affordable Care Act marketplace at Healthcare.gov. You can create an account, enter your income and household size, and see what plans are available in your area. Many young adults may have access to for subsidies that lower the monthly premium, even if they don't may have access to for Medicaid. The subsidy is based on your projected income for the year, so if you're not sure what you'll earn, estimate conservatively.

You can also check whether your employer offers health insurance. If you work full-time, your employer may cover part of the cost. Part-time jobs sometimes offer coverage too, though it's less common. If neither Medicaid nor marketplace coverage works for your budget, some states run programs for uninsured young adults — ask 211 what's available where you live.

Income limits and how they're calculated

Medicaid expansion states use 138% of the federal poverty line as their income limit. The federal poverty line changes every year — in 2024, it's $15,060 per year for a single person, making the Medicaid limit roughly $20,783 per year or $1,738 per month. This number is gross income, meaning it's calculated before taxes and deductions.

Your state Medicaid office will ask for recent pay stubs, tax returns, or other proof of income when you contact them. If your income fluctuates — you work gig jobs, seasonal work, or have irregular hours — bring documentation for the past three months and explain the variation. Some states average your income over time; others use your most recent month. Ask your state office which method they use before you apply.

If you're self-employed or have income from multiple sources, keep records of all of it. Medicaid counts all income, including side gigs, rental income, and money from family members if you're required to report it as household income.

What changes if you move to a different state

Your Medicaid coverage does not follow you if you move. If you move from an expansion state to a non-expansion state, you'll lose Medicaid and need to find new coverage through the marketplace or your employer. If you move from a non-expansion state to an expansion state, you may become newly may be able to access for Medicaid. In both cases, you have 60 days after moving to report the change to your old state's Medicaid office and contact your new state's office.

Moving is considered a "may have access to life event," which means you can enroll in a marketplace plan outside the normal open enrollment period. If you're moving between states, contact Healthcare.gov to report the move and see what coverage options are available in your new state. Don't wait — if you go uninsured during the transition, you may face a gap in coverage.

Frequently Asked Questions

Does Medicaid expansion mean I automatically get coverage?

No. Expansion means your state has chosen to cover adults at that income level, but you still need to contact your state Medicaid office and provide proof of income. The expansion opens the door; you have to walk through it by reaching out and completing the process your state requires.

What if I earn just above my state's Medicaid limit?

You may still may have access to for a subsidy through the Affordable Care Act marketplace, which uses a different income calculation. The marketplace often covers people who earn slightly too much for Medicaid. Create an account at Healthcare.gov and enter your income to see what you may have access to for.

Can I move to an expansion state to get Medicaid?

You can move for any reason, but Medicaid may be able to access is based on where you currently live, not where you're moving to. If you move to an expansion state, you become may be able to access once you establish residency there — usually within 30 to 60 days. Contact your new state's Medicaid office after you move to start the process.

What if my state expanded Medicaid but I still can't afford it?

Medicaid expansion itself is free — there's no premium. However, some expansion states charge small copays for certain services. If cost is still a barrier, ask your state Medicaid office about programs for people with very low income or contact 211 to learn about other local resources.

How do I know if my state's income limit has changed?

Income limits change every year because the federal poverty line changes. Call your state Medicaid office each year to confirm the current limit, or check the Kaiser Family Foundation's map, which updates annually. If your income was just above the limit last year, you may may have access to this year.