Medicaid Eligibility in 2027: Income Limits, State Rules & New Requirements

Updated October 2026 for the 2027 plan year

Who is eligible for Medicaid?

Medicaid is for people with limited income. Federal law requires every state to cover certain groups, and states can choose to cover more. That is why Medicaid eligibility looks different in every state.

The main groups Medicaid covers are:

• Children, often at higher income levels than adults, through Medicaid or the Children’s Health Insurance Program (CHIP).
• Pregnant people, who also have higher income limits in most states.
• Parents and caretaker relatives with low income.
• Adults 19 to 64 without dependent children, mainly in states that expanded Medicaid.
• Older adults and people with disabilities, often with both income and asset limits.

Medicaid covers lower-income adults and children, pregnant people, older adults and people with disabilities. States run it under federal requirements, and states and the federal government pay for it together (Medicaid.gov).

You also need to live in the state where you apply and meet citizenship or immigration rules. Those rules changed on October 1, 2026, as explained below.

What is the income limit for Medicaid in 2027?

In expansion states, the income limit for most adults is 138% of the federal poverty level (FPL). Coverage that starts in 2027 uses the 2026 HHS poverty guidelines, so the 2027 limit is $22,025 a year for one person. Non-expansion states set much lower limits for parents and often no adult limit at all.

Medicaid eligibility is checked against your current monthly income, not a full-year estimate. That matters if your income just dropped after a job loss. Marketplace subsidies, by contrast, are based on your expected income for the whole year.

These are yearly amounts from the 2026 HHS poverty guidelines. Alaska and Hawaii use higher guidelines. Medicaid counts income using Modified Adjusted Gross Income (MAGI) rules for most children, pregnant people, parents and expansion adults.

Did my state expand Medicaid?

Most states have, and it shapes Medicaid eligibility more than any other rule. According to the KFF Medicaid expansion tracker, 41 states including DC have adopted the Affordable Care Act (ACA) Medicaid expansion. The 10 that have not are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.

Expansion is the single biggest factor in adult Medicaid eligibility. In an expansion state, a single adult with low income usually qualifies. In a non-expansion state, the same adult usually doesn’t qualify unless they are pregnant, a parent with very low income, older or disabled.

Two non-expansion states are partial exceptions. Wisconsin covers adults up to 100% FPL through BadgerCare Plus. Georgia offers Georgia Pathways to Coverage to adults up to 100% FPL who meet a work or activity requirement, and its official site says Pathways rules change January 1, 2027.

KFF also notes that several expansion states have trigger laws that could end or change expansion if federal funding drops. None had ended expansion as of October 2026.

Medicaid eligibility by state: 31-state table

This table covers the 31 states where HonestyInsure publishes state guides. Expansion status comes from the KFF tracker (October 2026). Program names are each state’s official Medicaid program.

Each state link opens our 2027 guide for that state, with where to apply and how Medicaid works with the local Marketplace.

What is the Medicaid coverage gap?

The coverage gap is the biggest hole in Medicaid eligibility. It is where adults earn too much for their state’s Medicaid but too little for Marketplace tax credits. It only exists in states that did not expand Medicaid. KFF estimates about 1.2 million uninsured people were in the gap, based on 2024 data.

Here is why it happens. Marketplace premium tax credits start at 100% FPL. In expansion states, Medicaid covers everyone below 138% FPL, so there is no hole. In non-expansion states, an adult below 100% FPL often gets neither.

Texas has the lowest limit for parents in the country, at 15% FPL, according to the KFF coverage gap brief. Georgia and Wisconsin have no coverage gap, because both cover adults up to 100% FPL through waivers.

What are the 2027 Medicaid work requirements?

Starting no later than January 1, 2027, many Medicaid expansion adults ages 19 to 64 must show 80 hours a month of qualifying activity to keep or get coverage. This comes from federal law signed July 4, 2025 (Public Law 119-21, often called H.R. 1). The Centers for Medicare & Medicaid Services (CMS) set the details in an interim final rule published June 3, 2026.

Qualifying activities include work, community service, a work program, or school at least half-time, and you can combine them. Monthly income of at least 80 times the federal minimum wage also counts. New applicants must meet the requirement for at least one month before applying (CMS fact sheet).

Who is exempt from Medicaid work requirements?

The CMS fact sheet lists mandatory exemptions, including:

• Pregnant people and people eligible for postpartum coverage
• Parents, guardians and caretakers of a child 13 or under, or of a person with a disability
• American Indians and Alaska Natives, and former foster youth
• People who are medically frail or have special medical needs
• Veterans with a total disability rating
• People meeting TANF work rules or certain SNAP rules, and people in drug or alcohol treatment
• People enrolled in Medicare

States can also grant short-term hardship exemptions, and some may start earlier than January 2027. Check your state Medicaid agency for its start date and how to report hours.

How often do I have to renew Medicaid?

Most people renew Medicaid once a year. Starting in 2027, most expansion adults must renew every 6 months instead. CMS told states the change begins with renewals scheduled on or after January 1, 2027 (State Medicaid Director Letter #26-001, March 6, 2026).

Children, pregnant people, and older adults or people with disabilities in other eligibility groups keep the yearly schedule. American Indians and Alaska Natives are exempt from the 6-month rule.

Keep your address, phone and email current with your state agency. Many people lose coverage at renewal for paperwork reasons, such as a notice that went to an old address, even though they still qualify.

Can immigrants get Medicaid after October 1, 2026?

Fewer immigrants can. Since October 1, 2026, federal Medicaid and CHIP funding is generally limited to U.S. citizens and nationals, lawful permanent residents (green card holders), Cuban/Haitian entrants and Compact of Free Association (COFA) migrants. That rule comes from CMS State Health Official Letter #26-001 (April 8, 2026).

Refugees, asylees and humanitarian parolees who are not in those groups generally lost full federal Medicaid eligibility. Emergency Medicaid is still available. States can also still cover lawfully residing children and pregnant people (CMS).

The law did not change how the five-year waiting period applies to many green card holders. Marketplace subsidies have a similar change for 2027 coverage; see HealthCare.gov’s immigrant coverage page and our subsidy guide.

How do I apply for Medicaid?

You can apply for Medicaid any day of the year, with no enrollment window, and the state decides your Medicaid eligibility. Apply through your state Medicaid agency, or through HealthCare.gov or your state’s exchange. If you look eligible, the Marketplace sends your application to the state.

1. Gather proof. Have pay stubs or current income, Social Security numbers, immigration documents if they apply, and your household members’ details.
2. Apply once for the household. One application checks Medicaid, CHIP and Marketplace savings together.
3. Watch your mail. The state may ask for more documents; answer by the deadline.
4. Report changes. Tell the state about income, address or household changes, and in 2027 keep track of work-requirement hours if they apply to you.

What if I don’t qualify for Medicaid?

If you earn too much for Medicaid, you will usually qualify for a premium tax credit on a Marketplace plan, as long as your income is between 100% and 400% FPL. A denial from Medicaid or losing Medicaid usually opens a Special Enrollment Period, so you don’t have to wait for Open Enrollment.

For 2027 coverage, Open Enrollment runs November 1, 2026 to January 15, 2027 in HealthCare.gov states. Enroll by December 15 for coverage that starts January 1. Above 400% FPL ($63,840 for one person) there is no tax credit for 2027.

Other paths are worth checking too: children may qualify for CHIP even when parents don’t, and people 65 or older should look at Medicare. Our guide to Medicaid vs Medicare explains how the programs fit together, and affordable health insurance covers low-cost Marketplace options.

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Keep learning: Medicaid vs Medicare, 2027 health insurance subsidies, Special Enrollment Periods, the health insurance marketplace and how Honesty.AI works.