Prior to the Affordable Care Act, Medicaid eligibility was limited to specific low-income groups, such as the elderly, people with disabilities, children, pregnant women, and some parents.

The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($17,236 for an individual in 2019).

As of January 2020, 14 states have not adopted the ACA Medicaid expansion. Across all non-expansion states, 4.4 million uninsured nonelderly adults would become eligible for Medicaid if all opted to expand their programs.

Who would become eligible for Medicaid if these states chose to expand? The table below the map links you to state-specific fact sheets with key data that answers that question.

United States                                                   4,432,000 32%* U.S. Fact Sheet
Alabama                                                       224,000 47% Alabama Fact Sheet
Florida                                                       805,000 30% Florida Fact Sheet
Georgia                                                       474,000 34% Georgia Fact Sheet
Kansas                                                         80,000 33% Kansas Fact Sheet
Mississippi                                                       170,000 48% Mississippi Fact Sheet
Missouri                                                       205,000 37% Missouri Fact Sheet
North Carolina                                                       357,000 33% North Carolina  Fact Sheet
Oklahoma                                                       178,000 34% Oklahoma Fact Sheet
South Carolina                                                       194,000 38% South Carolina Fact Sheet
South Dakota                                                         30,000 39% South Dakota Fact Sheet
Tennessee                                                       221,000 33% Tennessee Fact Sheet
Texas                                                   1,454,000 30% Texas Fact Sheet
Wisconsin                                                         24,000 8% **
Wyoming                                                         16,000 28% Wyoming Fact Sheet

Notes & Sources:

* Share of the total uninsured population in all 14 non-expansion states.

** Although Wisconsin has not expanded Medicaid under the ACA, the state provides Medicaid eligibility to adults up to the poverty level under a waiver. Wisconsin is the only state that has not adopted expansion that provides full Medicaid coverage to adults without dependent children. As a result, a fact sheet was not created for Wisconsin.

Number of uninsured nonelderly adults who would become eligible for coverage under expansion, share of the uninsured nonelderly adult population, and parental status: Kaiser Family Foundation analysis of the 2018 American Community Survey (ACS), 1-Year Estimates.

2019 Medicaid Eligibility Levels: Tricia Brooks, Lauren Roygardner, Samantha Artiga, and Amrutha Ramaswamy, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey (Washington, D.C.: Kaiser Family Foundation, March 2019),

Who Are Uninsured Adults Who Would Become Eligible for Medicaid if All States Expanded?: Kaiser Family Foundation analysis of the 2018 American Community Survey (ACS), 1-Year Estimates.

Where Do Uninsured Adults Who Would Be Eligible for Medicaid if All States Expanded Live? Kaiser Family Foundation analysis of the 2018 American Community Survey (ACS), 1-Year Estimates.

Geographic areas are defined by PUMAs, or Public-Use Microdata Areas. PUMAs are geographic areas defined as a collection of counties or tracts within counties with more than 100,000 people, based on the decennial census population counts. We use PUMA designations available on the public-use ACS microdata files.

What is the Potential Impact of Medicaid Expansion?: Larisa Antonisse, Rachel Garfield, Robin Rudowitz, and Madeline Guth, The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review (Washington, D.C.: Kaiser Family Foundation, August 2019),

How Would the Medicaid Expansion be Financed?:

Go to Source

Who Could Get Covered Under Medicaid Expansion?: State Fact Sheets