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Where Are States Today? Medicaid and CHIP Eligibility Levels for Children, Pregnant Women, and Adults

This fact sheet provides Medicaid and CHIP eligibility levels for children, pregnant women, parents, and other non-disabled adults as of January 2018, based on annual state survey data.1 The data highlight the central role Medicaid and CHIP play in covering low-income children and pregnant women and show Medicaid’s expanded role for low-income adults under the Affordable Care Act (ACA). See Tables 1-3 for state-specific data.

As of January 2018, 49 states cover children with incomes up to at least 200% of the federal poverty level (FPL, $41,560 per year for a family of three in 2018) through Medicaid and CHIP (Figure 1, Table 1 and 1A). This count includes 19 states that cover children with incomes at or above 300% FPL. Only two states (ID and ND) limit children’s eligibility to below 200% FPL. Across states, the upper Medicaid/CHIP eligibility limit for children ranges from 175% FPL in North Dakota to 405% FPL.

Figure 1: Income Eligibility Levels for Children in Medicaid/CHIP, January 2018

Most states extend coverage to pregnant women beyond the federal minimum of 138% FPL through Medicaid and CHIP. As of January 2018, 34 states cover pregnant women with incomes at or above 200% FPL ($41,560 per year for a family of three in 2018), including 12 states (including DC) that cover pregnant women with family incomes above 250% FPL. Five states extend coverage for pregnant women through CHIP and 16 states use CHIP funding to provide coverage through the unborn child option, under which states cover income-eligible pregnant women regardless of immigration status (Figure 2, Table 2).

Figure 2: Income Eligibility Levels for Pregnant Women in Medicaid/CHIP, January 2018

As of January 2018, 32 states cover parents and other adults with incomes up to 138% FPL ($28,676 per year for a family of three and $16,753 per year for an individual in 2018) under the ACA Medicaid expansion to low-income adults (Figures 3 and 4, Table 3). The District of Columbia extends eligibility beyond the expansion limit to parents with incomes up to 221% FPL and other adults with incomes up to 215%, and Alaska covers parents with incomes up to 139% FPL.

Figure 3: Medicaid Income Eligibility Levels for Parents, January 2018

Figure 4: Medicaid Income Eligibility Levels for Other Adults, January 2018

In the 19 states that have not expanded Medicaid, the median eligibility limit for parents is 43% FPL ($8,935 per year for a family of three in 2018) and other adults remain ineligible, except in Wisconsin (Figure 5). In 11 of these states, parent eligibility is at less than half of the poverty level, and only two of these states (ME and WI) cover parents at or above poverty. Wisconsin is the only non-expansion state that provides full Medicaid coverage to other adults, although eligibility at 100% FPL remains below the expansion level and the state does not receive the enhanced match available for expansion adults for this coverage.2 In the non-expansion states, 2.4 million adults with incomes above the Medicaid eligibility limit but below poverty fall into a coverage gap; they are ineligible for Medicaid and do not qualify for subsidies for Marketplace coverage, which become available at 100% FPL.3

Figure 5: Medicaid Income Eligibility Limits for Adults in States that Have Not Implemented the Medicaid Expansion, January 2018

In sum, Medicaid and CHIP continue to be central sources of coverage for the low-income population, but eligibility varies widely across groups and states. Medicaid and CHIP provide a base of coverage to low-income children and pregnant women nationwide. Eligibility for adults has grown in states that implemented the Medicaid expansion, but remains limited in states that have not expanded. There could be continued gains in eligibility for adults if additional states expand Medicaid, which would reduce the number of poor uninsured adults that fall into the coverage gap. However, states moving forward with expansion may seek waivers to add requirements or restrictions for adults as a condition of expanding.
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Table 1: Income Eligibility Limits for Children’s Health Coverage as a Percent of the Federal Poverty Level, January 20181
State Upper Income Limit Medicaid Coverage for
Infants Ages 0-12
Medicaid Coverage for
Children Ages 1-52
Medicaid Coverage for
Children Ages 6-182
Separate CHIP  for Uninsured Children
Ages 0-183
Medicaid Funded CHIP-Funded for Uninsured Children Medicaid Funded CHIP-Funded for Uninsured Children Medicaid Funded CHIP-Funded for Uninsured Children
Median4 255% 195% 217% 149% 216% 142% 155% 254%
Alabama5 317% 146% 146% 146% 107%-146% 317%
Alaska 208% 177% 159%-208% 177% 159%-208% 177% 124%-208%
Arizona 205% 152% 146% 138% 104%-138% 205%
Arkansas 216% 147% 147% 147% 107%-147% 216%
California6 266% 208% 208%-266% 142% 142%-266% 133% 108%-266%
Colorado 265% 147% 147% 147% 108%-147% 265%
Connecticut 323% 201% 201% 201% 323%
Delaware 217% 217% 194%-217% 147% 138% 110%-138% 217%
District of Columbia 324% 324% 206%-324% 324% 146%-324% 324% 112%-324%
Florida7 215% 211% 192%-211% 145% 138% 112%-138% 215%
Georgia 252% 210% 154% 138% 113%-138% 252%
Hawaii 313% 191% 191%-313% 139% 139%-313% 133% 105%-313%
Idaho 190% 147% 147% 138% 107%-138% 190%
Illinois8 318% 147% 147% 147% 108%-147% 318%
Indiana9 262% 218% 157%-218% 165% 141%-165% 165% 106%-165% 262%
Iowa 380% 380% 240%-380% 172% 172% 122%-172% 307%
Kansas10 241% 171% 154% 138% 113%-138% 241%
Kentucky 218% 200% 142% 142%-164% 133% 109%-164% 218%
Louisiana 255% 142% 142%-217% 142% 142%-217% 142% 108%-217% 255%
Maine 213% 196% 162% 140%-162% 162% 132%-162% 213%
Maryland 322% 194% 194%-322% 138% 138%-322% 133% 109%-322%
Massachusetts11 305% 205% 185%-205% 155% 133%-155% 155% 114%-155% 305%
Michigan 217% 195% 195%-217% 160% 143%-217% 160% 109%-217%
Minnesota12 288% 275% 275%-288% 280% 280%
Mississippi 214% 199% 148% 138% 107%-138% 214%
Missouri 305% 201% 148% 148%-155% 148% 110%-155% 305%
Montana 266% 148% 148% 148% 109%-148% 266%
Nebraska 218% 162% 162%-218% 145% 145%-218% 133% 109%-218%
Nevada 205% 165% 165% 138% 122%-138% 205%
New Hampshire 323% 196% 196%-323% 196% 196%-323% 196% 196%-323%
New Jersey 355% 199% 147% 147% 107%-147% 355%
New Mexico 305% 240% 200%-305% 240% 200%-305% 190% 138%-245%
New York 405% 223% 154% 154% 110%-154% 405%
North Carolina13 216% 215% 194%-215% 215% 141%-215% 138% 107%-138% 216%
North Dakota 175% 152% 152% 138% 111% – 138% 175%
Ohio 211% 156% 141%-211% 156% 141%-211% 156% 107%-211%
Oklahoma14 210% 210% 169%-210% 210% 151%-210% 210% 115%-210%
Oregon 305% 190% 133%-190% 138% 138% 100%-138% 305%
Pennsylvania 319% 220% 162% 138% 119%-138% 319%
Rhode Island 266% 190% 190%-266% 142% 142%-266% 133% 109%-266%
South Carolina 213% 194% 194%-213% 143% 143%-213% 133% 107%-213%
South Dakota 209% 187% 147%-187% 187% 147%-187% 187% 111%-187% 209%
Tennessee15 255% 195% 195%-216% 142% 142%-216% 133% 109%-216% 255%
Texas 206% 203% 149% 138% 101%-138% 206%
Utah 205% 144% 144% 138% 105%-138% 205%
Vermont 317% 317% 237%-317% 317% 237%-317% 317% 237%-317%
Virginia 205% 148% 148% 148% 109%-148% 205%
Washington 317% 215% 215% 215% 317%
West Virginia 305% 163% 146% 138% 108%-138% 305%
Wisconsin16 306% 306% 191% 133% 101%-156% 306%
Wyoming 205% 159% 159% 138% 119%-138% 205%
SOURCE: Based on a national survey conducted by the Kaiser Family Foundation with the Georgetown University Center for Children and Families, 2018.
Table presents rules in effect as of January 1, 2018.

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Table 1A: Income Eligibility Limits for Children’s Health Coverage Based on Annual Income for a Family of Three, January 20181
State Upper Income Limit Medicaid Coverage for
Infants Ages 0-12
Medicaid Coverage for
Children Ages 1-52
Medicaid Coverage for
Children Ages 6-182
Separate CHIP  for Uninsured Children
Ages 0-183
Medicaid Funded CHIP-Funded for Uninsured Children Medicaid Funded CHIP-Funded for Uninsured Children Medicaid Funded CHIP-Funded for Uninsured Children
Median4 $54,038 $40,728 $45,300 $31,585 $45,092 $30,338 $32,105 $52,677
Alabama5 $65,872 $30,338 $30,338 $30,338 $30,338 $65,872
Alaska $54,038 $45,984 $54,038 $45,984 $54,038 $45,984 $54,038
Arizona $42,599 $31,585 $30,338 $28,676 $28,676 $42,599
Arkansas $44,884 $30,546 $30,546 $30,546 $30,546 $44,884
California6 $55,274 $43,222 $55,274 $29,507 $55,274 $27,637 $55,274
Colorado $55,067 $30,546 $30,546 $30,546 $30,546 $55,067
Connecticut $67,119 $41,767 $41,767 $41,767 $67,119
Delaware $45,092 $45,092 $45,092 $30,546 $28,676 $28,676 $45,092
District of Columbia $67,327 $67,327 $67,327 $67,327 $67,327 $67,327 $67,327
Florida7 $44,677 $43,845 $43,845 $30,131 $28,676 $28,676 $44,677
Georgia $52,365 $43,638 $32,001 $28,676 $28,676 $52,365
Hawaii $74,807 $45,649 $74,807 $33,221 $74,807 $31,787 $74,807
Idaho $39,482 $30,546 $30,546 $28,676 $28,676 $39,482
Illinois8 $66,080 $30,546 $30,546 $30,546 $30,546 $66,080
Indiana9 $54,443 $45,300 $45,300 $34,287 $34,287 $34,287 $34,287 $54,443
Iowa $78,964 $78,964 $78,964 $35,741 $35,741 $35,741 $63,794
Kansas10 $50,079 $35,533 $32,001 $28,676 $28,676 $50,079
Kentucky $45,300 $41,560 $29,507 $34,079 $27,637 $34,079 $45,300
Louisiana $52,989 $29,507 $45,092 $29,507 $45,092 $29,507 $45,092 $52,989
Maine $44,261 $40,728 $33,663 $33,663 $33,663 $33,663 $44,261
Maryland $66,911 $40,313 $66,911 $28,676 $66,911 $27,637 $66,911
Massachusetts11 $63,379 $42,599 $42,599 $32,209 $32,209 $32,209 $32,209 $63,379
Michigan $45,092 $40,521 $45,092 $33,248 $45,092 $33,248 $45,092
Minnesota12 $59,846 $57,145 $59,846 $58,184 $58,184
Mississippi $44,469 $41,352 $30,754 $28,676 $28,676 $44,469
Missouri $63,379 $41,767 $30,754 $32,209 $30,754 $32,209 $63,379
Montana $55,274 $30,754 $30,754 $30,754 $30,754 $55,274
Nebraska $45,300 $33,663 $45,300 $30,131 $45,300 $27,637 $45,300
Nevada $42,599 $34,287 $34,287 $28,676 $28,676 $42,599
New Hampshire $67,119 $40,728 $67,119 $40,728 $67,119 $40,728 $67,119
New Jersey $73,769 $41,352 $30,546 $30,546 $30,546 $73,769
New Mexico $63,379 $49,872 $63,379 $49,872 $63,379 $39,482 $50,911
New York $84,159 $46,339 $32,001 $32,001 $32,001 $84,159
North Carolina13 $44,884 $44,677 $44,677 $44,677 $44,677 $28,676 $28,676 $44,884
North Dakota $36,365 $31,585 $31,585 $28,676 $28,676 $36,365
Ohio $43,845 $32,416 $43,845 $32,416 $43,845 $32,416 $43,845
Oklahoma14 $43,638 $43,638 $43,638 $43,638 $43,638 $43,638 $43,638
Oregon $63,379 $39,482 $39,482 $28,676 $28,676 $28,676 $63,379
Pennsylvania $66,288 $45,716 $33,663 $28,676 $28,676 $66,288
Rhode Island $55,274 $39,482 $55,274 $29,507 $55,274 $27,637 $55,274
South Carolina $44,261 $40,313 $44,261 $29,715 $44,261 $27,637 $44,261
South Dakota $43,430 $38,858 $38,858 $38,858 $38,858 $38,858 $38,858 $43,430
Tennessee15 $52,989 $40,521 $44,884 $29,507 $44,884 $27,637 $44,884 $52,989
Texas $42,806 $42,183 $30,962 $28,676 $28,676 $42,806
Utah $42,599 $29,923 $29,923 $28,676 $28,676 $42,599
Vermont $65,872 $65,872 $65,872 $65,872 $65,872 $65,872 $65,872
Virginia $42,599 $30,754 $30,754 $30,754 $30,754 $42,599
Washington $65,872 $44,677 $44,677 $44,677 $65,872
West Virginia $63,379 $33,871 $30,338 $28,676 $28,676 $63,379
Wisconsin16 $63,586 $63,586 $39,689 $27,637 $32,416 $63,586
Wyoming $42,599 $33,040 $33,040 $28,676 $28,676 $42,599
SOURCE: Based on a national survey conducted by the Kaiser Family Foundation with the Georgetown University Center for Children and Families, 2018.
Table presents rules in effect as of January 1, 2018.

Table 1 and Table 1A Notes

  1. January 2018 income limits reflect Modified Adjusted Gross Income (MAGI)-converted income standards and include a disregard equal to five percentage points of the federal poverty level (FPL) applied at the highest income level for Medicaid and separate CHIP coverage. Eligibility levels are reported as percentage of the FPL. The 2018 FPL for a family of three was $20,780.
  2. States may use Title XXI CHIP funds to cover children through CHIP-funded Medicaid expansion programs and/or separate child health insurance programs for children not eligible for Medicaid. Use of Title XXI CHIP funds is limited to uninsured children. The Medicaid income eligibility levels listed indicate thresholds for children covered with Title XIX Medicaid funds and uninsured children covered with Title XXI funds through CHIP-funded Medicaid expansion programs. To be eligible in the infant category, a child has not yet reached his or her first birthday; to be eligible in the 1-5 category, the child is age one or older, but has not yet reached his or her sixth birthday; and to be eligible in the 6-18 category, the child is age six or older, but has not yet reached his or her 19th
  3. The states noted use federal CHIP funds to operate separate child health insurance programs for children not eligible for Medicaid. Such programs may either provide benefits similar to Medicaid or a somewhat more limited benefit package. They also may impose premiums or other cost sharing obligations on some or all families with eligible children. These programs typically provide coverage for uninsured children until the child’s 19th birthday.
  4. Medians for CHIP-funded uninsured children are based on the upper limit of coverage.
  5. Alabama, the District of Columbia, Oklahoma, and Tennessee have different lower bounds for adolescents in Title XXI funded Medicaid expansions depending on age. The lower bound for Title XXI funded Medicaid is 18% for children ages 14 through 18 in Alabama, 63% for children ages 15 through 18 in the District of Columbia, 69% for children ages 14 through 18 in Oklahoma, and 29% for children ages 14 through 18 in Tennessee.
  6. In California, children with higher incomes are eligible for separate CHIP coverage in certain counties.
  7. In Florida, all infants are covered in Medicaid. Florida operates three separate CHIP programs: Healthy Kids covers children ages 5 through 18; MediKids covers children ages 1 through 4; and the Children’s Medical Service Network serves children with special health care needs from birth through age 18.
  8. In Illinois, infants born to non-Medicaid covered mothers are covered up to 147% FPL in Medicaid and up to 318% FPL under CHIP.
  9. Indiana uses a state-specific income disregard that is equal to five percent of the highest income eligibility threshold for the group.
  10. Kansas covers children in a separate CHIP program at a dollar-based income level equal to 238% FPL in 2008. As a result, the equivalent FPL level may erode over time although it was increased in 2014 to account for the MAGI conversion and includes the five percentage point disregard required under MAGI.
  11. Massachusetts also covers insured children in its separate CHIP program with Title XIX Medicaid funds under its Section 1115 waiver.
  12. In Minnesota, the infant category under Title XIX-funded Medicaid includes insured and uninsured children up to age two with incomes up to 275% FPL
  13. In North Carolina, all children ages 0 through 5 are covered in Medicaid while the separate CHIP program covers children ages 6 through 18 with incomes above Medicaid limits.
  14. Oklahoma offers a premium assistance program to children ages 0 through 18 with income up to 222% FPL with access to employer sponsored insurance through its Insure Oklahoma program.
  15. In Tennessee, Title XXI funds are used for two programs, TennCare Standard and CoverKids (a separate CHIP program). TennCare Standard provides Medicaid coverage to uninsured children who lose eligibility under TennCare (Medicaid), have no access to insurance, and have family income below 216% FPL or are medically eligible.
  16. In Wisconsin, children are not eligible for CHIP if they have access to health insurance coverage through a job where the employer covers at least 80% of the cost.

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Table 2: Medicaid and CHIP Income Eligibility Limits for Pregnant Women, January 2018
State Percent of the Federal Poverty Level1 Annual Income
Medicaid1 CHIP1 Unborn Child Option
(CHIP-Funded)1,2
Medicaid1 CHIP1 Unborn Child Option
(CHIP-Funded)1,2
Median or Total 200% 258% 214% $41,560 $53,612 $44,365
Alabama 146% $30,338
Alaska 205% $53,259
Arizona 161% $33,455
Arkansas3 214% 214% $44,469 $44,469
California 213% 322% $44,261 $66,911
Colorado 200% 265% $41,560 $55,067
Connecticut 263% $54,651
Delaware 217% $45,092
District of Columbia4 324% $67,327
Florida 196% $40,728
Georgia 225% $46,755
Hawaii 196% $46,844
Idaho 138% $28,676
Illinois 213% 213% $44,261 $44,261
Indiana5 218% $45,300
Iowa 380% $78,964
Kansas 171% $35,533
Kentucky 200% $41,560
Louisiana 138% 214% $28,676 $44,469
Maine 214% $44,469
Maryland 264% $54,859
Massachusetts 205% 205% $42,599 $42,599
Michigan 200% 200% $41,560 $41,560
Minnesota 283% 283% $58,807 $58,807
Mississippi 199% $41,352
Missouri 201% 305% 305% $41,767 $63,379 $63,379
Montana 162% $33,663
Nebraska 199% 202% $41,352 $41,975
Nevada 165% $34,287
New Hampshire 201% $41,767
New Jersey4 199% 205% $41,352 $42,599
New Mexico 255% $52,989
New York4 223% $46,339
North Carolina6 201% $41,767
North Dakota 152% $31,585
Ohio 205% $42,599
Oklahoma7 138% 210% $28,676 $43,638
Oregon 190% 190% $39,482 $39,482
Pennsylvania 220% $45,716
Rhode Island 195% 258% 258% $40,521 $53,612 $53,612
South Carolina 199% $41,352
South Dakota8 138% $28,676
Tennessee9 200% 255% $41,560 $52,989
Texas 203% 207% $42,183 $43,014
Utah 144% $29,923
Vermont 213% $44,261
Virginia 148% 205% $30,754 $42,599
Washington 198% 198% $41,144 $41,144
West Virginia 163% $33,871
Wisconsin 306% 306% $63,586 $63,586
Wyoming 159% $33,040
SOURCE: Based on a national survey conducted by the Kaiser Family Foundation with the Georgetown University Center for Children and Families, 2018.
Table presents rules in effect as of January 1, 2018.

Table 2 Notes

  1. January 2018 income limits reflect Modified Adjusted Gross Income (MAGI)-converted income standards, and include a disregard equal to five percentage points of the federal poverty level (FPL). As of 2018, the FPL for a family of three was $20,780.
  2. The unborn child option permits states to consider the fetus a “targeted low-income child” for purposes of CHIP coverage.
  3. Arkansas provides the full Medicaid benefits to pregnant women with incomes up to levels established for the old Aid to Families with Dependent Children (AFDC) program, which is $220 per month. Above those levels, more limited pregnancy-related benefits are provided to pregnant women covered under Medicaid and the unborn child option in CHIP with incomes up to 209% FPL.
  4. The District of Columbia, New Jersey, and New York provide pregnancy-related services not covered through emergency Medicaid for some income-eligible pregnant women who are not otherwise eligible due to immigration status using state-only funds.
  5. Indiana uses a state-specific income disregard that is equal to five percent of the highest income eligibility threshold for the group.
  6. North Carolina provides full Medicaid benefits to pregnant women with incomes up to roughly 43% FPL. Above that level, more limited pregnancy-related benefits are provided to pregnant women covered under Medicaid.
  7. Oklahoma offers a premium assistance program to pregnant women with incomes up to 205% FPL who have access to employer sponsored insurance through its Insure Oklahoma program.
  8. South Dakota provides full Medicaid benefits to pregnant women with incomes up to $591 per month (for a family of three). Above that level, more limited pregnancy-related benefits are provided to pregnant women covered under Medicaid.
  9. In Tennessee, women covered under the unborn child option receive comprehensive medical services but do not receive chiropractic, dental or vision benefits that CHIP children receive.

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Table 3: Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level, January 20181
State Percent of the Federal Poverty Level Annual Income
Parents
(in a family of three)
Other Adults
(for an individual)
Parents
(in a family of three)
Other Adults
(for an individual)
Median 138% 138% $28,676 $16,753
Alabama 18% 0% $3,740 $0
Alaska 139% 138% $36,112 $20,948
Arizona2 138% 138% $28,676 $16,753
Arkansas2 138% 138% $28,676 $16,753
California3 138% 138% $28,676 $16,753
Colorado 138% 138% $28,676 $16,753
Connecticut4 138% 138% $28,676 $16,753
Delaware 138% 138% $28,676 $16,753
District of Columbia5 221% 215% $45,923 $26,101
Florida 33% 0% $6,857 $0
Georgia 36% 0% $7,480 $0
Hawaii5 138% 138% $32,982 $19,264
Idaho 26% 0% $5,402 $0
Illinois6 138% 138% $28,676 $16,753
Indiana2, 7 139% 139% $28,884 $16,874
Iowa2 138% 138% $28,676 $16,753
Kansas 38% 0% $7,896 $0
Kentucky 138% 138% $28,676 $16,753
Louisiana 138% 138% $28,676 $16,753
Maine8 105% 0% $21,819 $0
Maryland 138% 138% $28,676 $16,753
Massachusetts5, 9 138% 138% $28,676 $16,753
Michigan2 138% 138% $28,676 $16,753
Minnesota10 138% 138% $28,676 $16,753
Mississippi 27% 0% $5,610 $0
Missouri 22% 0% $4,571 $0
Montana2 138% 138% $28,676 $16,753
Nebraska 63% 0% $13,091 $0
Nevada 138% 138% $28,676 $16,753
New Hampshire2 138% 138% $28,676 $16,753
New Jersey 138% 138% $28,676 $16,753
New Mexico5 138% 138% $28,676 $16,753
New York5, 10 138% 138% $28,676 $16,753
North Carolina 43% 0% $8,935 $0
North Dakota 138% 138% $28,676 $16,753
Ohio 138% 138% $28,676 $16,753
Oklahoma11 43% 0% $8,935 $0
Oregon5 138% 138% $28,676 $16,753
Pennsylvania5 138% 138% $28,676 $16,753
Rhode Island 138% 138% $28,676 $16,753
South Carolina 67% 0% $13,922 $0
South Dakota 50% 0% $10,390 $0
Tennessee 98% 0% $20,364 $0
Texas12 18% 0% $3,740 $0
Utah13 60% 0% $12,468 $0
Vermont14 138% 138% $28,676 $16,753
Virginia15 38% 0% $7,896 $0
Washington 138% 138% $28,676 $16,753
West Virginia 138% 138% $28,676 $16,753
Wisconsin16 100% 100% $20,780 $12,140
Wyoming 55% 0% $11,429 $0
SOURCE: Based on a national survey conducted by the Kaiser Family Foundation with the Georgetown University Center for Children and Families, 2018.
Table presents rules in effect as of January 1, 2018.

Table 3 Notes

  1. January 2018 income limits reflect Modified Adjusted Gross Income (MAGI)-converted income standards, and include a disregard equal to five percentage points of the Federal Poverty Level (FPL) applied to the highest income limit for the group. In some states, eligibility limits for Section 1931 parents are based on a dollar threshold. The values listed represent the truncated FPL equivalents calculated from these dollar limits. Eligibility levels for parents are presented as a percentage of the 2018 FPL for a family of three, which is $20,780. Eligibility limits for other adults are presented as a percentage of the 2018 FPL for an individual, which is $12,140.
  2. Arizona, Arkansas, Indiana, Iowa, Michigan, Montana and New Hampshire implemented the Medicaid expansion under Section 1115 waiver authority.
  3. In 2017, California began using state-only funds to cover otherwise eligible adults regardless of immigration status.
  4. Connecticut decreased eligibility for parents and caretaker relatives as of January 1, 2018.
  5. The District of Columbia, Hawaii, Massachusetts, New Mexico, New York, and Pennsylvania cover some income-eligible adults who are not otherwise eligible due to immigration status using state-only funds. Oregon began providing reproductive health benefits regardless of immigration status as of January 1, 2018.
  6. Parents have been covered in Illinois in an optional group under Title XIX up to 133% FPL from July 2012 to January 2014.
  7. Indiana uses a state-specific income disregard that is equal to five percent of the highest income eligibility threshold for the group.
  8. Maine has passed a ballot initiative to expand Medicaid but it had not yet been implemented as of January 2018.
  9. Massachusetts provides subsidies for Marketplace coverage for parents and childless adults with incomes up to 300% through its Connector Care program. The state’s Section 1115 waiver also authorizes MassHealth coverage for HIV-positive individuals with incomes up to 200% FPL, uninsured individuals with breast or cervical cancer with incomes up to 250% FPL, and individuals who work for a small employer and purchase employer-sponsored insurance (ESI) with incomes up to 300% FPL, as well as coverage through MassHealth CommonHealth for adults with disabilities with no income limit, provided that they have either met a one-time deductible or are working disabled adults.
  10. Minnesota and New York have implemented Basic Health Programs (BHPs) established by the Affordable Care Act (ACA) for adults with incomes between 138%-200% FPL.
  11. In Oklahoma, individuals without a qualifying employer with incomes up to 100% FPL are eligible for more limited subsidized insurance though the Insure Oklahoma Section 1115 waiver program. Individuals working for certain qualified employers with incomes at or below 222% FPL are eligible for premium assistance for employer-sponsored insurance.
  12. In Texas, the income limit for parents and other caretaker relatives is based on monthly dollar amounts which differ depending on family size and whether there is one or two-parents in the family. The eligibility level shown is for a single parent household and a family size of three.
  13. In 2017, Utah increased eligibility for parents from 45% to 60% FPL, including the 5 percentage point disregard, and changed parent eligibility from a dollar to FPL based threshold. In 2017, Utah also received waiver approval and is covering childless adults with incomes up to 5% FPL who are chronically homeless or in need of behavioral health treatment as of January 2018. Adults with incomes up to 100% FPL continue to be eligible for coverage of primary care services under the Primary Care Network Section 1115 waiver program in Utah. Enrollment is opened periodically when there is capacity to accept new enrollees.
  14. Vermont also provides a 1.5% reduction in the federal applicable percentage of the share of premium costs for individuals who qualify for advance premium tax credits to purchase Marketplace coverage with income up to 300% FPL.
  15. In Virginia, eligibility levels for 1931 parents vary by region. The value shown is the eligibility level for Region 2, the most populous region.
  16. Wisconsin covers adults up to 100% FPL in Medicaid but did not adopt the ACA Medicaid expansion.
Endnotes
  1. Tricia Brooks, et. al., Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey, (Washington, DC: Kaiser Family Foundation, January 2018), available at https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2018-findings-from-a-50-state-survey/.

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  2. Oklahoma and Utah provide more limited coverage to some childless adults under Section 1115 waiver authority.

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  3. Rachel Garfield and Anthony Damico, The Coverage Gap: Uninsured Poor Adults in States that do not Expand Medicaid, (Washington, DC: Kaiser Family Foundation, November 2017), available at https://www.kff.org/uninsured/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/.

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