Free Health Insurance in 2027
Who Qualifies, State by State

Which States Have Free Healthcare?

No U.S. state gives every resident free health insurance. What changes from state to state is who can get coverage for $0: whether the state expanded Medicaid to adults up to 138% of the poverty level, whether it adds its own $0-premium program above that line, and which exchange you use to apply for Marketplace tax credits. Every state does offer CHIP, which gives children low-cost coverage (HealthCare.gov).

The table covers the 42 jurisdictions where FreedInsure’s licensed agent, Constantino Lardi (NPN 20230457), is licensed: 41 states and Washington, DC. The nine states where our agent isn’t licensed (Colorado, Connecticut, Idaho, Massachusetts, Minnesota, New Mexico, Rhode Island, Vermont and Washington) have all expanded Medicaid (KFF). Medicaid dollar figures are for one person under the 2026 HHS poverty guidelines; they move to the 2027 guidelines in early 2027.

The 138% limit is the 133% limit in federal law plus a standard 5% income disregard, so some states publish it as 133%. Alaska and Hawaii use their own, higher poverty guidelines. Expansion status is from KFF; exchange types are from CMS’s plan year 2027 list. Arkansas and Oklahoma run state-based exchanges on the federal platform, so enrollment still happens on HealthCare.gov, and Oregon moves from HealthCare.gov to Explore Health for 2027 coverage.

• Washington, DC cut its adult Medicaid limits to 138% of the poverty level on January 1, 2026 (DC Department of Health Care Finance).
• Georgia Pathways covers adults up to 100% of the poverty level who meet a monthly 80-hour work or activity requirement; CMS extended it through December 31, 2026.
• Kansas and South Carolina cover parents and caretaker relatives only at very low incomes (38% and 62% of the poverty level). In the non-expansion states other than Wisconsin, adults without dependent children generally can’t qualify on income alone.
• South Dakota votes in November 2026 on a constitutional amendment that would end expanded Medicaid if federal funding for it drops below 90%, according to the state Attorney General’s ballot statement.

States With $0 Coverage Beyond Medicaid

• New York: the Essential Plan has a $0 premium and no deductible for eligible adults 19–64 with income up to 200% of the poverty level ($31,920 for one person under the 2026 guidelines) who can’t get Medicaid (NY State of Health).
• Oregon: OHP Bridge covers adults with income between 133% and 200% of the poverty level, with no member costs (Oregon Health Authority).
• Washington, DC: the Healthy DC Plan covers residents under 65 with income over 138% and up to 200% of the poverty level who don’t have affordable job-based coverage, with no monthly premiums (DC Health Benefit Exchange Authority). FreedInsure doesn’t enroll DC residents in it.
• California: a state subsidy adds to federal tax credits for incomes up to 200% of the poverty level in 2027, and Covered California says nearly 200,000 people can choose from two Silver plans with a $0 premium (Covered California).
• New Jersey: NJ Health Plan Savings adds state help on top of federal tax credits for households up to 600% of the poverty level (NJ Department of Banking and Insurance).

Maine, Maryland, Nevada, Pennsylvania, Virginia and DC

FreedInsure doesn’t sell ACA Marketplace plans in these six jurisdictions. Residents apply for Marketplace tax credits through the state exchange linked in the table, and for Medicaid through that exchange or the state Medicaid agency. In Maine, Maryland, Nevada, Pennsylvania and Virginia, FreedInsure can compare private health plans sold outside the ACA Marketplace, short-term plans where they’re available (none are currently sold in Maine), supplemental coverage and life insurance; in DC, we can help with life insurance and supplemental coverage. These plans are not sold through the ACA Health Insurance Marketplace (HealthCare.gov or your state’s exchange) and are not individual-market ACA plans. You can’t use a premium tax credit or cost-sharing reduction to pay for them. As HealthCare.gov puts it, “the only way to get the premium tax credit is through the Marketplace” (HealthCare.gov).

Important: Plans sold outside the ACA Marketplace may be subject to underwriting, age limits, state availability and each plan’s own eligibility rules. Not all plans are available in all states. Rates are not guaranteed and can change. Benefits, limits and exclusions are set by the official plan document or policy, which controls if it differs from this page. This page is a general summary, not a contract or an offer of coverage.

Everywhere else on this list, FreedInsure, which works with 14+ carriers, can compare the Marketplace plans in your ZIP code and estimate your 2027 tax credit at no cost to you. FreedInsure’s licensed agent is Constantino Lardi, NPN 20230457, and two of our licensed staff speak Spanish. Call (844) 788-3733 or check your eligibility →

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