State Medicaid and CHIP Eligibility Guidelines


The Affordable Care Act (also known as “Obamacare”) creates a national minimum eligibility standard of 133% of the federal poverty level (FPL), but some states choose not to adopt the Medicaid expansion under the ACA.

Listed below are the Medicaid and CHIP eligibility levels as a % of federal poverty level (FPL) in each state1 — as of June 2016.2

State
Not Expanding
Infants
0 > 1
Child
1 – 5
Child
6 – 19
CHIP
0 – 19
Pregnant
Women
Parents
*Family of 3
Adults
19 – 65
Alabama 141% 141% 141% 312% 141% 13% 0%
Florida 206% 140% 133% 210% (1 – 18) 191% 21% 0%
Georgia 205% 149% 133% 247% 220% 34% 0%
Idaho 142% 142% 133% 185% 133% 24% 0%
Kansas 166% 149% 133% 238% 166% 33% 0%
Maine 191% 157% 157% 208% 209% 100% 0%
Mississippi 194% 143% 133% 209% 194% 23% 0%
Missouri 196% 150% 150% 300% 196% 18% 0%
Nebraska 213% 213% 213% N/A 194% 58% 0%
North Carolina 210% 210% 133% 211% (6 – 18) 196% 44% 0%
Oklahoma 205% 205% 205% N/A 133% 41% 0%
South Carolina 208% 208% 208% N/A 194% 62% 0%
South Dakota 182% 182% 182% 204% 133% 57% 0%
Tennessee 195% 142% 133% 250% 195% 103% 0%
Texas 198% 144% 133% 201% 198% 15% 0%
Utah 139% 139% 133% 200% 139% 44% 0%
Virginia 143% 143% 143% 200% 143% 49% 0%
Wisconsin 301% 186% 151% 301% (1 – 18) 301% 95% 95%
Wyoming 154% 154% 133% 200% 154% 55% 0%

Among the 19 states not expanding Medicaid coverage, the median eligibility level for parents is just 47% FPL, with only two (2) states — Maine and Tennessee covering parents with incomes at or above poverty. Only Wisconsin is providing full Medicaid coverage to adults without dependent children.

State
Expanding
Infants
0 > 1
Child
1 – 5
Child
6 – 19
CHIP
0 – 19
Pregnant
Women
Parents
*Family of 3
Adults
19 – 65
Alaska 203% 203% 203% N/A 200% 142% 133%
Arizona 147% 141% 133% 200%3 156% 106% 133%
Arkansas 142% 142% 142% 211% 209% 17% 133%
California 261% 261% 261% 317% 208% 109% 133%
Colorado 142% 142% 142% 260% 195% 68% 133%
Connecticut 196% 196% 196% 318% 258% 150% 133%
Delaware 212% 142% 133% 212% (1 – 18) 212% 87% 133%
District of Columbia 319% 319% 319% N/A 319% 216% 210%
Hawaii 308% 308% 308% N/A 191% 105% 133%
Illinois 142% 142% 142% 313% 208% 133% 133%
Indiana 208% 158% 158% 250% 208% 19% 133%
Iowa 375% 167% 167% 302% (1 – 18) 375% 54% 133%
Kentucky 195% 159% 159% 213% 195% 23% 133%
Louisiana 212% 212% 212% 250% 133% 19% 133%
Maryland 317% 317% 317% N/A 259% 123% 133%
Massachusetts 200% 150% 150% 300% 200% 133% 133%
Michigan 212% 212% 212% N/A 195% 54% 133%
Minnesota 283%4 275% 275% N/A 278% 133% 200%
Montana 143% 143% 143% 261% 157% 24% 133%
Nevada 160% 160% 133% 200% 160% 32% 133%
New Hampshire 318% 318% 318% N/A 196% 68% 133%
New Jersey 194% 142% 142% 350% 194% 32% 133%
New Mexico 300% 300% 240% N/A 250% 46% 133%
New York 218% 149% 149% 400% 218% 133% 200%
North Dakota 147% 147% 133% 170% 147% 52% 133%
Ohio 206% 206% 206% N/A 200% 90% 133%
Oregon 185% 133% 133% 300% 185% 40% 133%
Pennsylvania 215% 157% 133% 314% 215% 33% 133%
Rhode Island 261% 261% 261% N/A 190% 116% 133%
Vermont 312% 312% 312% N/A 208% 53% 133%
Washington 210% 210% 210% 312% 193% 40% 133%
West Virginia 158% 141% 133% 300% 158% 19% 133%

  1. Eligibility levels reflect MAGI converted income standards that include a five percentage point of the federal poverty level disregard and are subject to change. []
  2. Medicaid.gov, Medicaid and CHIP Eligibility Levels for for Adults, Children, and Pregnant Women []
  3. The separate CHIP program in Arizona has been closed to new applicants and will begin new enrollment on September 1, 2016. []
  4. Minnesota covers children up to age 2 with income up to 283% of the FPL. []