All states Texas
Texas Medicaid: who can actually get it
Texas Medicaid is run by Texas Health and Human Services Commission (HHSC). Children are covered through Children's Medicaid (via STAR), with CHIP just above that. Texas never expanded Medicaid, so who qualifies here is far narrower than most people expect.
The income limit is far lower than almost anyone expects
a month — the most a parent in a family of three can earn and still get Texas Medicaid
And that figure has not moved since 2015.
Texas sets this as a fixed dollar amount, not a percentage of the federal poverty line. The underlying number — $230 a month before the standard work-expense deduction — was last revised in October 2015.
It does not rise with inflation, and it does not rise when the poverty line does. So every year the cost of living goes up while this number stands still, the bar quietly gets harder to stay under, and fewer working parents qualify than the year before. It is the lowest parent threshold in the United States — about 15% of the poverty line.
Source: Texas Works Handbook C-130, Revision 26-2, effective April 1, 2026.
Children can qualify even when their parents can't. The limit for a child here is several times the limit for that child's parent, so it is entirely normal for a family to end up with the kids covered and the adults not. If that is your household, apply for the children anyway — it costs nothing to try, and they may be eligible today.
A note on these figures. We publish what Texas Health and Human Services Commission (HHSC)'s current eligibility documentation says — Texas Works Handbook C-130, Revision 26-2, effective April 1, 2026. Some other published analyses and a few of the state's own consumer pages show slightly different numbers, because they have not been updated to the latest revision. The agency decides either way: apply and let them calculate it.
605,000 people here earn too much for Medicaid and too little for help buying a plan
They sit above Texas's very low Medicaid limit but below the poverty line, which is where federal help with premiums begins. There is nothing in between. This is the largest in the nation — Florida is second at 267,000.
The gap runs from roughly $0 to about $13,300 a year for an individual — from nothing to about 85% of the poverty level. Figures from KFF, June 2026, using 2024 ACS. Credible estimates for Texas range from 570,000 to 726,000 depending on the survey year used; we quote the most recent.
The new work requirement does not apply in Texas
Nobody here will be asked to prove 80 hours a month.
The federal work requirement in H.R. 1 applies only to adults covered through Medicaid expansion. Texas never adopted expansion and has no qualifying waiver, so there is no such group in this state and the requirement does not reach it.
If you have seen national news about 80 hours a month, proving your work, or renewing every six months — that reporting is about other states. It does not apply to your Texas coverage.
Some things do change here on January 1, though.
P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.
What the marketplace can and cannot do for you
The standard advice is “try the marketplace.” For some people here that is good advice. For others it is simply untrue, and it matters a great deal which one you are.
The marketplace is not an expensive option. It is not an option.
Help with premiums starts at the poverty line. Below it there is no subsidy at all, at any price. That is what makes this a gap rather than a cost problem.
It works this way because the law assumed every state would extend Medicaid up to that line, and Texas did not. What is left for you:
- ~75 Federally Qualified Health Centers with hundreds of sites, sliding scale — findahealthcenter.hrsa.gov
- Children may qualify for Children's Medicaid or CHIP even when parents don't
- Healthy Texas Women for family planning only
You can buy a plan, but it costs more than it did last year.
The enhanced premium tax credits expired at the end of 2025. Smaller credits still exist for household incomes between 100% and 400% of the poverty line, but the share you pay yourself went up.
Marketplace enrollment in this state went from 3,420,000 to 3,280,000 this year — 4% — Texas's first year-over-year ACA enrollment decline since 2020, though better than the 12% national average.
Source: Texas Tribune, July 9, 2026.
Do this now
Applying is free and you can do it any time of year — Medicaid has no open-enrollment window. If you are not sure whether you qualify, apply anyway and let the state work it out. Deciding for yourself that you don't qualify is the most common way people miss coverage they were entitled to.
About the phone numbers: 2-1-1 cannot be dialled from outside Texas, from some mobile phones, or over VoIP — the page must give 877-541-7905 alongside it, not as an afterthought.
Deaf, hard of hearing or speech-impaired: 7-1-1 or 1-800-735-2989.
Full Spanish site at hhs.texas.gov/es. Vietnamese gets an automatic translation interpreter form attached to eligibility notices. 150+ other languages via the 2-1-1 interpreter line — press 0 after choosing a language. Written materials beyond English and Spanish are limited by policy; the interpreter line is the real access point.
Most people who lose coverage lose it over paperwork, not eligibility
68.2% of the coverage losses recorded in Texas were procedural — a form, a deadline, or an address, rather than a real change in whether someone qualified. Which means the letter is usually the thing that decides it.
NOTICE OF ELIGIBILITY DETERMINATION
Case number: ███████
Date of this notice: 1January 12, 2027
Based on the information available to us, your household is no longer eligible for Texas Medicaid.
2If you believe this determination is incorrect, you may request a fair hearing on or before February 11, 2027.
3Coverage for other members of your household may continue. A separate notice is enclosed for each person.
What the federal data says about coverage here
Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what three of those numbers mean if you are the person enrolled.
Of people who lost coverage here, this share lost it over paperwork rather than eligibility.
Open every letter. Keep your address current with the agency, not just the post office.
Records here are relatively accurate. If a notice says something is missing, treat it as real rather than assuming a mistake at the agency.
Quintile 1 of 5.
Doctors are scarce here by national standards. Nurse practitioners also need physician supervision in this state, which narrows your options further.
Book an appointment before you need one, not when you do.
342,575 people in Texas are on a waiting list for home and community-based services. If you need long-term care at home rather than in a facility, get your name on the list as early as you can — the wait is measured in years, and it starts when you apply, not when you need it.
Questions people ask about this
Does the new Medicaid work requirement apply in Texas?
Can an adult with no children get Medicaid in Texas?
What is the income limit for parents on Texas Medicaid?
Can my children qualify if I don't?
What changes on January 1, 2027 in Texas?
How do I apply for Texas Medicaid?
Guides for nearby states
The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.
Texas has the strictest parent income limit in the country — about $344 a month for a family of three — and that dollar figure has not moved since 2015.
Applying costs nothing and takes about twenty minutes. If you are anywhere near the line, let the state decide rather than deciding for them.
Apply at YourTexasBenefits.com →