Medicaid Income Limits by State: The 2026 Numbers and What Changes in 2027
In the 41 states that expanded Medicaid (DC included), an adult qualifies with income up to 138% of the poverty line — about $22,025 a year, or $45,540 for a family of four. Here's every state, the monthly math and what changes in 2027.
Get My Free 2027 Quote ↓What Is the Income Limit for Medicaid in 2026?
Medicaid income limits for adults are set at 138% of the federal poverty level (FPL) in the 41 Medicaid expansion states, including DC. On the 2026 HHS poverty guidelines, that's $22,025 a year for one person and $45,540 for a family of four, with higher figures in Alaska and Hawaii.
The 138% figure is the 133% limit in federal law plus a standard 5% income disregard. Children, pregnant women and people with disabilities qualify through separate pathways; see how to qualify for Medicaid. This page covers the adult income numbers and what changes as 2027 open enrollment gets underway.
FreedInsure LLC (NPN: 20230457) is an independent brokerage licensed in 42 states. Medicaid isn't something we sell, but the line between Medicaid and a subsidized Marketplace plan is where we work every day — 100% free. Call (844) 788-3733.
Quick answer: Medicaid income limits in the 41 expansion states (including DC) are 138% of the federal poverty level: about $22,025 a year ($1,835 a month) for one person and $45,540 for a family of four in 2026. Alaska ($27,531) and Hawaii ($25,337) run higher for a single adult. In the 10 states that haven't expanded, adult limits are lower, and many adults can't qualify on income alone.
Medicaid Income Limits by Household Size (2026)
At 138% FPL, the 2026 limit is $22,025 for one person and $45,540 for four in the 48 contiguous states and DC — about $1,835 a month for a single adult. Alaska and Hawaii use their own, higher guidelines.
👤 1 Person
$22,025 a year, about $1,835 a month. That's 138% of the $15,960 poverty guideline.
👪 Family of 4
$45,540 a year, about $3,795 a month. That's 138% of the $33,000 poverty guideline.
❄️ Alaska
$27,531 for one person and $56,925 for four, built on Alaska's higher guidelines ($19,950 and $41,250 at 100%).
🌴 Hawaii
$25,337 for one person and $52,371 for four, built on Hawaii's higher guidelines ($18,360 and $37,950 at 100%).
Each extra household member adds $5,680 to the 2026 guideline (the step from $15,960 for one to $33,000 for four), or about $7,838 at 138%: roughly $29,863 for two people and $37,702 for three.
Medicaid generally measures current income, so the monthly figure is often the one that counts. The 2026 guidelines took effect January 13, 2026, unless a program sets a different date; your state agency's chart has the final word.
Medicaid Income Limits by State: Who Expanded and Who Didn't
Forty-one states, counting DC, have expanded Medicaid; 10 have not: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. Status is from KFF as of August 21, 2026; state names link to our free health insurance by state guides where we have one.
| State | Expanded Medicaid? | Adult Limit, 1 / 4 People (2026) |
|---|---|---|
| Alabama | No | No expansion group |
| Alaska | Yes | $27,531 / $56,925 |
| Arizona | Yes | $22,025 / $45,540 |
| Arkansas | Yes | $22,025 / $45,540 |
| California | Yes | $22,025 / $45,540 |
| Colorado | Yes | $22,025 / $45,540 |
| Connecticut | Yes | $22,025 / $45,540 |
| Delaware | Yes | $22,025 / $45,540 |
| District of Columbia | Yes | $22,025 / $45,540 |
| Florida | No | No expansion group |
| Georgia | No (Pathways) | Up to 100% FPL (about $15,960 for one), with a work requirement |
| Hawaii | Yes | $25,337 / $52,371 |
| Idaho | Yes | $22,025 / $45,540 |
| Illinois | Yes | $22,025 / $45,540 |
| Indiana | Yes | $22,025 / $45,540 |
| Iowa | Yes | $22,025 / $45,540 |
| Kansas | No | No expansion group |
| Kentucky | Yes | $22,025 / $45,540 |
| Louisiana | Yes | $22,025 / $45,540 |
| Maine | Yes | $22,025 / $45,540 |
| Maryland | Yes | $22,025 / $45,540 |
| Massachusetts | Yes | $22,025 / $45,540 |
| Michigan | Yes | $22,025 / $45,540 |
| Minnesota | Yes | $22,025 / $45,540 |
| Mississippi | No | No expansion group |
| Missouri | Yes | $22,025 / $45,540 |
| Montana | Yes | $22,025 / $45,540 |
| Nebraska | Yes | $22,025 / $45,540 |
| Nevada | Yes | $22,025 / $45,540 |
| New Hampshire | Yes | $22,025 / $45,540 |
| New Jersey | Yes | $22,025 / $45,540 |
| New Mexico | Yes | $22,025 / $45,540 |
| New York | Yes | $22,025 / $45,540 |
| North Carolina | Yes (Dec 1, 2023) | $22,025 / $45,540 |
| North Dakota | Yes | $22,025 / $45,540 |
| Ohio | Yes | $22,025 / $45,540 |
| Oklahoma | Yes | $22,025 / $45,540 |
| Oregon | Yes | $22,025 / $45,540 |
| Pennsylvania | Yes | $22,025 / $45,540 |
| Rhode Island | Yes | $22,025 / $45,540 |
| South Carolina | No | No expansion group |
| South Dakota | Yes (July 1, 2023) | $22,025 / $45,540 |
| Tennessee | No | No expansion group |
| Texas | No | No expansion group |
| Utah | Yes | $22,025 / $45,540 |
| Vermont | Yes | $22,025 / $45,540 |
| Virginia | Yes | $22,025 / $45,540 |
| Washington | Yes | $22,025 / $45,540 |
| West Virginia | Yes | $22,025 / $45,540 |
| Wisconsin | No (waiver) | Up to 100% FPL (about $15,960 for one) through a waiver |
| Wyoming | No | No expansion group |
Two nuances: Wisconsin covers adults up to 100% FPL through a Section 1115 waiver, and Georgia Pathways covers adults up to 100% FPL with work requirements (under a CMS extension that runs through December 31, 2026), yet KFF counts both as not adopted. The newest expansion states are North Carolina (December 1, 2023) and South Dakota (July 1, 2023). The dollar figures show the 138% FPL expansion line for adults 19 to 64; your state's own Medicaid chart has the final word on its limits.
In non-expansion states, adults without dependent children usually can't qualify at any income. Earn under 100% FPL there and you may fall into the coverage gap, below the 100% FPL floor for Marketplace tax credits. Some states also have trigger laws tied to federal funding, so confirm your state's status before applying.
Will Medicaid Income Limits Change in 2027?
The 138% line stays, but the dollar amounts will change. Medicaid uses the current year's poverty guidelines, and HHS publishes new ones each January, so Medicaid income limits for 2027 move to the 2027 guidelines in early 2027. They aren't published yet, so any 2027 Medicaid dollar figure you see today is an estimate.
Each state switches on the HHS effective date or a later date it chooses. Apply in November or December 2026 and you're measured against the 2026 figures: $22,025 for one person, $45,540 for four.
The timing trap: Medicaid and the Marketplace use different years
Marketplace savings use the prior year's guidelines for the whole coverage year, so 2027 tax credits stay on the 2026 guidelines: $15,960 to $63,840 for one person and roughly $33,000 to $132,000 for a family of four. In early 2027, Medicaid's line is redrawn on new numbers while your Marketplace credit still uses the old ones.
Income near 138% FPL? Check your eligibility on both sides of the line; you can cross it in either direction when income shifts or the 2027 guidelines take effect. Losing Medicaid later opens a 60-day Special Enrollment Period, so a program switch needn't leave you uninsured.
Do You Have to Work to Get Medicaid in 2027?
If you're an expansion adult aged 19 to 64 and not exempt, a federal work requirement is scheduled to apply by January 1, 2027. You'd need 80 hours a month of work, community service, a work program or at least half-time education — or monthly earnings of at least $580 (the 2026 figure). It isn't in effect yet in most states.
Medicaid work requirements for 2027 come from Section 71119 of the 2025 federal budget law and a CMS interim final rule published June 3, 2026. They cover non-pregnant expansion adults (and certain Section 1115 waiver groups) who aren't entitled to or enrolled in Medicare; KFF counts 44 states, including DC, as subject. States check at application and renewal, and applicants must show at least one month of compliance before the month they apply.
Exemptions include pregnant or postpartum people; people who are disabled or medically frail; parents and caretakers of children under 14 or of people with disabilities; American Indians and Alaska Natives; certain veterans; former foster youth; and others.
The date is less certain than it looks. HHS can grant a state a good-faith exemption lasting no later than December 31, 2028. KFF reported planned early starts in Nebraska (May 1, 2026), Montana (July 1, 2026) and Iowa (December 1, 2026), plus an Arkansas soft launch July 1, 2026 with disenrollment planned from January 2027. Those are announced plans; confirm with your state. Also scheduled for expansion adults: six-month renewals (starting with renewals on or after December 31, 2026) and retroactive coverage cut to one month on January 1, 2027.
What If You Earn Too Much for Medicaid?
Between 138% and 400% FPL in an expansion state, or between 100% and 400% FPL in a state that didn't expand, a Marketplace plan with a premium tax credit is usually your best path. For 2027 coverage, credits run from $15,960 to $63,840 for one person. Open enrollment on HealthCare.gov runs November 1, 2026 through January 15, 2027; enroll by December 15 for a January 1 start. Some state exchanges set their own dates, so check yours.
Just over the line, the credit is generous: the IRS's 2027 table sets the expected benchmark Silver contribution from 2.15% of income (under 133% FPL) to 10.22% (300% to 400% FPL). At 150% FPL ($23,940 for one person), that's 4.30%, about $86 a month, with the credit covering the rest. Below about 250% FPL, cost-sharing reduction Silver plans also cut deductibles. See our ACA income limits guide or run the 2027 ACA subsidy calculator.
Two warnings. The enhanced credits of 2021–2025 are gone and not back for 2027 under current law, unless Congress acts, so the 400% FPL cliff is back: $1 over and the credit is $0. And if you qualify for Medicaid while on a Marketplace plan, the credit won't stop automatically; keep using it and you'll repay it, with no repayment cap starting tax year 2026. Here's how to cancel Marketplace insurance without a gap.
Straight talk: Medicaid is a government program, not something we sell. Under about 138% FPL in an expansion state, Medicaid is the answer — we'll say so and point you to your state's application (see how to apply for Medicaid). Between that line and 400% FPL, or between 100% and 400% FPL in a non-expansion state, a Marketplace plan with a tax credit is the move, and that's where a free broker earns their keep. Call (844) 788-3733.
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