Medicaid is changing. Here's what you need to do.

Plain-language help for all 50 states and Washington, D.C. — whether you're signing up for the first time, checking whether you're still covered, or trying to hold on to what you have.

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73.5M

people covered by Medicaid & CHIP

fewer than a year ago

104

days until the new rules start

states & D.C. affected

Start here

What brings you here today?

Showing — across this page.

All 50 states & D.C.

Find out what's changing where you live

Every state runs Medicaid differently, calls it something different, and is on a different timeline for the new rules. Pick yours.

Each square is one state, sized equally so every state is easy to tap. A ringed square means that state's full guide is ready — click straight through to it. Prefer a list? Use the dropdown at the top of the page.

In effect nowNebraska, Montana and Arkansas started ahead of the federal deadline.

Starts by Jan 1, 202740 states plus D.C., and Georgia, Tennessee and Wisconsin through waivers. Iowa begins December 1, 2026.

Doesn't apply hereSeven states with no expansion and no qualifying waiver — though other 2027 changes still reach you.

Hover or tap a state
See its status and program name.

Arkansas is live — it's the ringed square on the map. Click it to open the full state guide. Every other state shows its status here; those guides are on the way.

January 1, 2027

Four things are changing

Under the 2025 federal law known as H.R. 1, adults aged 19–64 in the Medicaid expansion group face new requirements. Here's the whole of it, in plain terms.

Hours a month

Working, going to school at least half-time, job training, or volunteering. You can mix and match to reach 80.

$580

Or this much earned

Earn at least $580 in a month and you've met it, however many hours that took. Partial earnings count toward the 80.

Months between renewals

Renewals move from once a year to every six months for most adults in the expansion group.

Days to respond

If your state can't confirm you qualify, you get a notice and 30 days to show proof or that you're exempt.

Many people don't have to meet these rules at all

This is the part almost nobody has explained clearly. If any of these describe you, the 80-hour rule does not apply — but you may still need to tell your state, so don't assume they know.

Pregnant or postpartumThrough your pregnancy and the postpartum period.

Under 19 or 65 and olderThe rule covers ages 19 through 64 only.

Caring for a child or disabled family memberCertain caregivers are exempt.

Medically frailSerious illness, disability, or a substance use disorder.

A veteran with a total disability ratingFull VA disability ratings are exempt.

American Indian or Alaska NativeTribal members are exempt, and still renew yearly.

Already meeting SNAP or TANF work rulesYou don't have to prove it twice.

Enrolled in MedicareOr covered through another Medicaid category.

This isn't the complete list, and states are still finalizing how they'll check. Your state may also grant short-term hardship exceptions — for a hospital stay, a natural disaster, or a lack of transport. When in doubt, call your state and ask.

Am I eligible?

The income limit, for your household

In the 40 states and D.C. that expanded Medicaid, adults qualify up to 138% of the federal poverty level. Move the counter to your household size.

How many people are in your household?

1 person

Income limit for Medicaid

$1,835

per month, before deductions

$22,025 a year

›Alaska and Hawaii use higher limits — roughly 25% and 15% above these figures.

›Children, pregnant women, seniors and people with disabilities usually qualify at higher incomes than this.

Things people get wrong

Your household isn't who lives with you. Medicaid counts who's on your tax return — you, your spouse, and anyone you claim as a dependent.
It's this year's income that matters, not last year's. If your hours were cut or you lost a job, apply now rather than waiting.
Seven states never expanded. In Alabama, Florida, Kansas, Mississippi, South Carolina, Texas and Wyoming, adults without children generally can't qualify at any income.
Being over the limit isn't the end. If you earn too much for Medicaid, you may qualify for a low-cost or free marketplace plan instead.

If a letter arrives

Most people who lose coverage lose it over paperwork

Not because they stopped qualifying. A letter like this shows up, it's confusing, and the deadline passes. Here's what one looks like — and what actually matters in it.

State Medicaid Agency · Notice of Action

REQUEST FOR INFORMATION — COMMUNITY ENGAGEMENT

Case number: ██████████
Date of notice: 1January 12, 2027

We are reviewing your eligibility. Our records do not show that you meet the community engagement requirement described in Section 1902(xx) of the Social Security Act.

2You must submit documentation of qualifying activities on or before February 11, 2027.

3If we do not receive this information, your benefits will be discontinued effective March 1, 2027.

4If you believe this notice is in error, or that an exemption applies to you, you may request a State Hearing.

Find this date first.Your 30 days runs from the date printed on the notice — not the day it reached your mailbox. Assume you have less time than you think.

This is the deadline that counts.Pay stubs, a class schedule, or a letter from where you volunteer all work. Send something even if it feels incomplete — a partial response keeps your case open.

Your coverage doesn't stop that day.There's a gap between the deadline and the end date. If you've missed the first one, you still have time — use it.

You may not need to do any of this.Pregnant, a caregiver, medically frail, a veteran with a disability rating, tribal, or already meeting SNAP work rules? You're exempt. Say so, in writing, before the deadline.

Know your state

What the data says about your program

Public federal data tells you a lot about how your state runs Medicaid — how often its paperwork goes wrong, how hard it is to find a doctor, whether you'll have to choose a plan. We translate it into things you can act on. Here's California as an example.

Procedural disenrollment · CMS

74.9%

3 in 4 Californians who lost coverage lost it over paperwork — not because they stopped qualifying.

Keep your address current. Open every letter.

Primary care supply · AHR

238/100k

Doctors are scarce here. Expect a wait for a new-patient appointment — book before you actually need one.

Nurse practitioners need physician supervision in California.

Managed care · KFF

Yes

You'll have to pick a health plan, not just enroll. If you don't choose, one gets chosen for you.

Check your doctor is in that plan's network first.

Don't wait for the letter.

We'll email you ahead of the deadlines that matter in your state — renewal dates, work-rule changes, and anything else that could put your coverage at risk.