Medicaid Expansion States: Full List of All 50 States + DC

Which States Have Expanded Medicaid?

Updated November 5, 2026. Results were still being counted; we’ll update this page as races are called and as Congress acts.

Medicaid expansion is the Affordable Care Act (ACA) option that opens Medicaid to most low-income adults, not just children, parents, pregnant people, older adults and people with disabilities. Each state decides whether to adopt it. KFF, the health policy research group, tracks each state’s status; our list uses its data. Wisconsin and Georgia run partial programs to 100% of the federal poverty level (FPL), but KFF counts both as not expanded.

This page is part of our election coverage. For the bigger picture, read what the 2026 midterms mean for your health insurance.

FreedInsure is a private insurance agency, not HealthCare.gov, a state Medicaid agency or a government website. Medicaid eligibility is decided by your state. This page is general information, not legal advice.

Last updated: November 5, 2026

What Is the Medicaid Expansion Income Limit?

In expansion states, adults 19 to 64 qualify with household income up to 138% of the federal poverty level. The law sets 133%, and a standard 5% income disregard brings it to 138%. Using the 2026 HHS poverty guidelines:

These dollar figures will change in early 2027. Medicaid and CHIP use the current year’s poverty guidelines, and HHS publishes new ones each January. Marketplace savings work differently: for 2027 coverage, they’re based on the 2026 guidelines all year. HealthCare.gov puts it this way: “2026 income is used to check if you’re eligible for Medicaid and CHIP.”

Above Medicaid’s limit, Marketplace premium tax credits can help with household income up to 400% FPL ($63,840 for one person). Under current law, there’s no credit above that. See ACA income limits and how to qualify for Medicaid.

What the November 2026 Election Changed for Medicaid Expansion

As of November 5, 2026, no state’s expansion status has changed because of the election.

South Dakota: Amendment I rejected (unofficial)

South Dakota voters rejected Amendment I by about 56% to 44% in unofficial returns, Managed Healthcare Executive reported. NBC/AP data showed 44.2% yes and 55.8% no, with 99% of the expected vote in. Official results were expected the following week.

The amendment would have tied the state’s constitutional Medicaid expansion to a federal match of at least 90%. Managed Healthcare Executive reported it could have ended expansion for about 31,000 residents if the federal share fell below 90%; its sponsor said it would have let lawmakers decide rather than end coverage automatically.

Governors’ races in non-expansion states

• Georgia: NBC News projected Democrat Keisha Lance Bottoms the winner over Republican Rick Jackson, 54.3% to 45.7%. The Atlanta Journal-Constitution reported that she has a chance to act on the long-standing Democratic pledge to expand Medicaid, and noted that a 2014 state law requires legislative approval to broaden eligibility.
• Texas: The Texas Tribune reported that Democrat Gina Hinojosa defeated Gov. Greg Abbott after campaigning on expanding Medicaid.
• Wisconsin: Democrat David Crowley won the governor’s race (NBC News projection, 54.1% to 45.9%). The AP reported that he had called for expanding Medicaid coverage.
• Kansas: As of the evening of November 4, the race between Democrat Cindy Holscher, who campaigned on Medicaid expansion, and Republican Ty Masterson, who opposes it (Kansas Reflector, KCUR), was uncalled, with Holscher narrowly ahead in NBC News results, 50.3% to 49.7%.

A campaign promise isn’t an expansion. As of November 5, 2026, all ten non-expansion states remain on KFF’s not-expanded list (August 21, 2026 update). This table will change only when a state actually adopts expansion.

What to Do About Your 2027 Coverage

As of November 5, 2026, 2027 coverage is set under current law, so don’t wait for Congress or your state legislature.

1. If you may qualify for Medicaid, apply through your state Medicaid agency or HealthCare.gov. Medicaid and CHIP take applications year-round.
2. If your income is above Medicaid’s limit, compare Marketplace plans. On HealthCare.gov, enroll by December 15, 2026 for coverage that starts January 1, 2027. Open enrollment ends January 15, 2027. New York, New Jersey, California and DC run open enrollment to January 31, 2027, and each sets its own date for a January 1 start. See deadlines by state.
3. If Congress changes tax credits later, the 2021 precedent shows how that help reached people. The American Rescue Plan was signed March 11, 2021; larger savings reached HealthCare.gov on April 1 for people who updated their application, and earlier months could be claimed on the tax return. That help covered only months when people had Marketplace coverage. Read more on how backdated subsidies would work and whether the enhanced ACA tax credits will come back.

For dated updates as they happen, follow our ACA news tracker. For the reform debate, see public option vs. Medicare for All.