Medicaid Expansion
Free coverage for adults earning up to 138% of the federal poverty level — available year-round in 41 states and DC.
Last updated: May 2026
Medicaid expansion under the Affordable Care Act extends free or near-free health coverage to adults earning up to 138% of the federal poverty level — roughly $20,800/year for a single adult or $43,000/year for a family of four in 2026. If you live in an expansion state and your income qualifies, there are no premiums and no deductibles.
Which states have expanded Medicaid (as of 2026)
41 states and the District of Columbia have adopted Medicaid expansion. North Carolina expanded in December 2023 and South Dakota in July 2023. The 10 states that have not yet expanded are: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
In non-expansion states, adults earning above the state's traditional Medicaid cutoff but below 100% of the federal poverty level fall into the so-called "coverage gap" — too rich for Medicaid, too poor for Marketplace tax credits. We help you find every workaround available in your state.
Who qualifies in an expansion state
- Adults 19–64 with household income up to 138% FPL
- No asset test — only income counts
- You don't have to have children, a disability, or be pregnant to qualify
- U.S. citizens and most lawfully present immigrants who have met the 5-year bar
What expansion Medicaid covers
- Doctor visits, hospital stays, and emergency care
- Prescription drugs
- Mental health and substance use treatment
- Maternity and newborn care
- Preventive care, screenings, and vaccines at no cost
- Lab tests and X-rays
How to apply
You can apply year-round — Medicaid has no open-enrollment window. The fastest path is through your state's Medicaid agency or HealthCare.gov, which forwards expansion applications to your state automatically. A Zero Gap Health advisor can pre-check your eligibility, gather the right documents, and submit on your behalf at no cost.
See what you qualify for — free, in under 2 minutes.
Answer a few quick questions and a licensed advisor in your state will walk you through your options. No SSN required, no obligation.