Medicaid eligibility by state

What differs from state to state

Adults without children are where states split most. Forty-one jurisdictions, DC included, have adopted the ACA expansion and cover adults 19–64 to 138% of the poverty line; the year each started is in the table. Seven of them — Idaho, Maine, Missouri, Nebraska, Oklahoma, South Dakota and Utah — expanded because voters passed a ballot initiative, and thirteen have trigger laws that would end or scale back the expansion if federal funding drops.^[KFF] Wisconsin covers adults to 100% through a waiver and Georgia through Pathways, which requires 80 hours a month of activity; the other eight states offer adults without children no Medicaid at all.

Children are covered everywhere, but the ceiling ranges from 190% of the poverty line in Idaho to 405% in New York once CHIP is counted. Some states run a separate CHIP with its own name and premiums; others fold CHIP money into Medicaid.^[MACPAC]

Pregnancy limits run from 138% (Idaho, South Dakota) to 324% (DC), and nearly every state now keeps new mothers covered for 12 months after birth.^[KFF]

Rules on the move: the federal work requirement for expansion adults starts January 1, 2027, Nebraska began enforcing its own on May 1, 2026, DC cut adult eligibility on January 1, 2026, and Arkansas’s expansion waiver expires at the end of 2026. Each state page dates these changes.