General information only, not insurance or medical advice. Consult a licensed broker or visit HealthCare.gov for plan-specific guidance.
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Medicaid & CHIP

Medicaid, CHIP, and free coverage in 2026

Income below $21,597 (single) or $44,367 (family of 4) in an expansion state likely means free Medicaid coverage. Below: who qualifies and how to apply.

138 percent FPL income limits, 2026

In Medicaid expansion states, household income below these thresholds typically qualifies adults for free or near-free coverage. Contiguous US figures.

Household size138% FPL annual income
1 person$21,597
2 people$29,187
3 people$36,777
4 people$44,367
5 people$51,957
6 people$59,547

Expansion vs non-expansion states

Expansion states (41 + DC)

138% FPL coverage

Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia.

Non-expansion states (10)

Coverage gap risk

Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming.

Eligibility is much narrower in these states (typically children, parents under ~30% FPL, pregnant people, disabled adults).

The income zones for ACA coverage

Where you land on the income ladder determines what coverage you can access:

Below 138% FPL

Medicaid

Free or near-free coverage in expansion states. No premiums, minimal copays, no deductible.

138 to 400% FPL

Marketplace + subsidy

Premium tax credit caps cost at 2 to 9.78 percent of income. CSR Silver below 250 percent FPL adds richer cost-sharing.

Above 400% FPL

Full retail price

Marketplace at unsubsidised premium, or employer plan, or association / private coverage. The 2026 cliff applies.

Other free or low-cost options

CHIP for children

Up to 200 to 300% FPL depending on state. $0 to $50 a month per child. Routine, dental, vision, mental health.

Federally Qualified Health Centers

Sliding-scale community health centers. Available regardless of insurance status. Roughly 1,400 FQHCs nationally.

VA health benefits

Veterans with qualifying service receive comprehensive coverage. Priority groups determine cost. Apply via VA.gov.

Indian Health Service

Federal health system for American Indians and Alaska Natives. No premiums, no enrollment caps within eligibility.

Common questions

Who qualifies for Medicaid in 2026?

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In Medicaid expansion states (41 plus DC), adults under 65 with household income below 138 percent FPL qualify: $21,597 for an individual, $44,367 for a family of 4 in 2026. In non-expansion states, eligibility is much narrower and typically limited to children, parents with very low income, pregnant people, and people with disabilities.

What is the coverage gap?

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In the 10 non-expansion states, adults earning below 100 percent FPL ($15,650 single in 2026) often qualify for neither Medicaid nor marketplace subsidies. Subsidies start at 100 percent FPL by design, on the assumption Medicaid covers below that threshold. Around 1.5 million Americans are caught in this gap, mostly in the South.

How is CHIP different from Medicaid?

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Children's Health Insurance Program covers children in households with income too high for Medicaid but too low for unsubsidised marketplace coverage. Income limits range from 200 to 300+ percent FPL depending on state. Premiums are zero or token amounts. Coverage includes routine care, dental, vision, mental health, and preventive services. Children can sometimes qualify for CHIP even when parents enroll on the marketplace.

Can I have Medicaid and a marketplace plan at the same time?

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No. If you qualify for Medicaid, you cannot get a marketplace premium tax credit. Reporting income that makes you marketplace-eligible when you actually qualify for Medicaid can trigger a refund of subsidies at tax time. The marketplace will route Medicaid-eligible applicants to the state Medicaid agency automatically.

Is Medicaid free?

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For most enrollees in most states, yes. Premiums are zero. Some states charge token monthly premiums of $1 to $25 for households at the upper end of eligibility. Most services have no copay; some states charge $1 to $4 per visit or prescription. There are no deductibles in Medicaid.

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