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), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/.
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), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/.
How Would the Medicaid Expansion be Financed?: