Medicaid Expansion Status: Latest Decisions & Updates
- The Affordable Care Act (ACA) significantly broadened Medicaid eligibility by expanding coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level.
- This expansion also included an enhanced federal matching rate (FMAP) for states covering this newly eligible population, incentivizing participation.
- As of today, 41 states and the District of Columbia have adopted the Medicaid expansion.
Medicaid Expansion Under the Affordable Care Act
Table of Contents
Updated August 27, 2024
Expansion Overview
The Affordable Care Act (ACA) significantly broadened Medicaid eligibility by expanding coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level. For 2025, this income threshold is $21,597 for an individual, as defined by the Department of Health and Human Services (HHS) poverty guidelines.
This expansion also included an enhanced federal matching rate (FMAP) for states covering this newly eligible population, incentivizing participation.
State adoption status
As of today, 41 states and the District of Columbia have adopted the Medicaid expansion. Ten states have not yet expanded eligibility, according to tracking and analysis by the Kaiser Family Foundation (KFF).
Resources and Data
Detailed state-by-state facts on Medicaid expansion decisions is available in a comprehensive table format from KFF.
A downloadable presentation summarizing the current status of the Medicaid expansion is also available as a PowerPoint file from KFF.