Status of State Medicaid Expansion Decisions

The Affordable Care Act’s (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($20,783 for an individual in 2024) and provided states with an enhanced federal matching rate (FMAP) for their expansion populations.

To date, 41 states (including DC)   have adopted   the Medicaid expansion and 10 states   have not adopted   the expansion. Current status for each state is based on KFF tracking and analysis of state expansion activity.

These data are also available in a table format. The map may be downloaded as a Powerpoint.

Medicaid Expansion Resources

• New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending
• Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021
• The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020
• Effects of the ACA Medicaid Expansion on Racial Disparities in Health and Health Care
• The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
• Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic
• Medicaid: What to Watch in 2024
• Eliminating the ACA: What Could It Mean for Medicaid Expansion?
• Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
• The Uninsured and the ACA: A Primer – Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act
• Medicaid State Fact Sheets
• An Overview of State Approaches to Adopting the Medicaid Expansion