Medicaid Income Limits 2026

In a state that has adopted ACA Medicaid expansion, a single adult qualifies with a MAGI up to 138% of the Federal Poverty Level — $22,024.80 per year ($1,835.40 per month) in the 48 contiguous states plus DC for 2026. Alaska and Hawaii use higher FPL bases, so their dollar limits are higher. In the 10 states that have not expanded Medicaid, a childless adult with no waiver program generally isn't eligible for Medicaid regardless of income (the "coverage gap") — use the checker above to see your specific state.

Modified Adjusted Gross Income (MAGI) is the income measure Medicaid uses for most non-elderly, non-disabled applicants. It starts from your federal Adjusted Gross Income (AGI) and adds back a few items (like excluded foreign income and tax-exempt interest), but does not use pre-2014 methods like income disregards that varied by state. For most wage-earning applicants without unusual deductions, MAGI is close to gross income minus above-the-line adjustments (retirement contributions, student loan interest, etc.).

No. The ACA expansion adult group (42 CFR 435.119) is MAGI-based only — there is no asset or resource test, unlike some other Medicaid categories (such as long-term care Medicaid) that do test assets. If your MAGI is under the limit for your household size, assets like savings, retirement accounts, or a second car do not affect eligibility for this group.

The coverage gap describes childless, non-disabled, non-pregnant adults in non-expansion states who do not fit a traditional Medicaid category and may also fall below the usual income floor for ACA marketplace premium tax credits. Georgia and Wisconsin run waiver programs that close or narrow this gap; the other non-expansion states do not cover this adult category regardless of how low the person's income is.

Yes, and it went down. Through December 31, 2025 DC covered childless adults at 210% of the Federal Poverty Level and parents/caretakers at 216% (both plus the 5-percentage-point disregard) — far above the ACA expansion group. Effective January 1, 2026 DC moved both categories to the standard 133% plus the 5-percentage-point disregard, i.e. 138% FPL, the same threshold as every other expansion state. DC residents whose income exceeded 138% FPL lost Medicaid on December 31, 2025. The DC figures on this page use the 2026 threshold, not the pre-2026 one. Note that CMS's national eligibility-levels table still lists DC at 210% — that table carries an "as of December 1, 2023" date and has not caught up.

Pathways to Coverage is a Section 1115 Medicaid waiver that lets Georgia adults qualify for Medicaid up to 100% of the Federal Poverty Level, but only if they complete at least 80 hours per month of a qualifying activity — employment, school, job training, or community service. It is not full ACA expansion: Georgia has no 138% MAGI adult group. It does apply the 5-percentage-point MAGI disregard, though — CMS's approval covers adults "with income up to 95 percent (effectively 100 percent with the 5 percent income disregard) of the federal poverty level" — so, exactly as in Wisconsin, it is the lower 95% base standard rather than any absence of the disregard that keeps Georgia out of the expansion group. CMS temporarily extended the demonstration through December 31, 2026, and Georgia's request to extend it further is still pending.

Wisconsin runs a BadgerCare Reform Section 1115 waiver that covers childless adults up to 100% of the Federal Poverty Level. Unlike the 8 non-expansion, non-waiver states, Wisconsin has no coverage gap — but because it caps eligibility below the ACA expansion group's level, it is still not counted as an expansion state. Wisconsin does apply the 5-percentage-point MAGI disregard: CMS's approval of the demonstration describes the population as adults with incomes up to 95% FPL, "effectively 100 percent of the FPL including the five percent disregard". It is the lower 95% base standard, not the absence of the disregard, that keeps Wisconsin out of the expansion group.

Yes. A CMS interim final rule (Federal Register, June 3, 2026, document 2026-11094) requires states to implement an 80-hours-per-month community engagement (work) requirement for ACA expansion adults no later than January 1, 2027. This does not change 2026 eligibility — it is a forward-looking rule to be aware of if you expect to still be enrolled after the 2027 deadline.

Yes — nearly every state sets much higher Medicaid and CHIP income limits for children and pregnant women than for other adults, often 200%–300% FPL or higher. This page and calculator cover only the adult categories (single adults and parents/caretaker relatives). For children's or pregnancy-related Medicaid/CHIP limits, check your state Medicaid agency's website or Healthcare.gov, which can route you to the right program.

Yes. The Federal Poverty Guidelines that Medicaid limits are based on are republished by HHS every January, typically with a small increase tied to inflation. All the dollar figures on this page reflect the 2026 guidelines (effective January 13, 2026) — check back each January for updated figures, or use the calculator above, which is built to update automatically when the underlying guidelines change.