The Affordable Care Act (ACA) broadened Medicaid eligibility so that almost all adults whose earnings do not exceed 138 percent of the Federal Poverty Level, $21,597 for a single person in 2025, can receive coverage. The provision also granted states a federal matching rate for covered groups.
To date, 41 states, including DC, have adopted the Medicaid expansion, while 10 states have not. The current status for each state is based on tracking and analysis of state expansion activity.
Key states with expansion activity are tracked in a table, which includes information about original adoption and implementation of the ACA expansion. For non-expansion states, recent activity related to debate about adopting the ACA expansion is also included.
Some states, such as South Dakota and West Virginia, are considering action to put a law in place that would automatically terminate the expansion if federal funding is reduced. In Virginia, a budget amendment was introduced to remove automatic termination of the expansion from the state’s law.
Proposals to remove or scale back these laws have been introduced in Illinois and North Carolina.
