Medicaid Eligibility in 2026: Income Limits by State and Household Size
Medicaid is the largest health insurance program in the United States, covering over 90 million Americans. Since the Affordable Care Act, eligibility has expanded significantly — but it still varies by state, household size, and individual circumstances in ways that confuse millions of eligible people.
The ACA Expansion and What It Changed
The Affordable Care Act gave states the option to expand Medicaid to cover all adults with income up to 138% of the federal poverty level (FPL), regardless of family status, disability, or other categorical requirements. As of 2026, 40 states and DC have adopted expansion. In expansion states, a single adult earning up to approximately $20,782/year qualifies. In non-expansion states, eligibility for adults without children remains much more restricted.
2026 Income Limits: Expansion States
In states that have expanded Medicaid: 1 person: ~$20,782/year | 2 people: ~$28,208/year | 3 people: ~$35,634/year | 4 people: ~$43,056/year | 5 people: ~$50,482/year. These figures represent 138% of the 2026 federal poverty guidelines. Income is measured as Modified Adjusted Gross Income (MAGI) — slightly different from your tax return income.
Non-Expansion States
In states that have not expanded Medicaid, coverage for adults without children remains limited. These states typically only cover: adults with minor children (with very low income limits), pregnant women, people who are elderly, blind, or disabled (qualifying for SSI), and some other narrow categories. The 'coverage gap' — people who earn too much for traditional Medicaid but too little for ACA subsidies — remains a serious problem in these states.
Children, Pregnancy, and CHIP
Children under 19 have higher income thresholds for Medicaid and CHIP in every state — typically up to 200–300% FPL depending on the state. Pregnant women qualify for Medicaid in all states, with thresholds ranging from 133% to 200%+ FPL. CHIP covers children in families with income too high for Medicaid but too low for affordable private insurance.
How to Apply
Apply through your state's Medicaid agency or healthcare.gov. In expansion states, applications through healthcare.gov are automatically routed to Medicaid if your income qualifies. You can apply at any time of year — Medicaid has no open enrollment period. Eligibility can be retroactive up to 90 days before your application date in many states.
Bottom Line
If you're uninsured, apply for Medicaid now. The income thresholds are higher than most people assume — especially for families with children. If you're in a non-expansion state and fall in the coverage gap, check whether your state has a pending expansion ballot measure or whether your income qualifies for ACA marketplace subsidies.