As of early 2026, 10 states have not adopted the Affordable Care Act (ACA) Medicaid expansion, which means they do not provide coverage to all adults with incomes up to 138% of the federal poverty level. These states maintain more restrictive eligibility criteria, leaving many low-income adults in a "coverage gap":
Which states have decided to not expand Medicaid eligibility?
No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.
Every state's Medicaid and CHIP program is changing and improving – most states are expanding coverage for low-income adults; all states are modernizing their Medicaid/CHIP eligibility, enrollment and renewal processes and systems, and taking advantage of many of the new flexibilities provided by the Affordable Care ...
The 10 worst programs—ranked in order from 50 to 41—are Mississippi, Texas, Idaho, Oklahoma, South Dakota, Indiana, South Carolina, Colorado, Alabama, and Missouri, the report concluded.
Vermont, Utah and Minnesota topped the Commonwealth Fund's Medicare performance scorecard in 2025, whereas Kentucky, Mississippi and Louisiana struggled the most.
Reimbursement rates are often lower than private insurance rates, and the administrative burden of billing Medicaid can be high. These factors can make it difficult for practices to sustain themselves and provide care to all patients.
One cannot transfer their Medicaid benefits from one state to another state, nor can they receive Medicaid benefits simultaneously in two states. Instead, one must close their Medicaid case, and hence their benefits, in their original state, and then reapply for Medicaid in the state to which they are relocating.
What is Medicaid called in your state?
New Mexico had the highest percentage of residents enrolled in Medicaid in 2022, while Utah had the lowest, according to new data released by the Census Bureau Sept.
Having said that, most states do give physicians discretion on whether to accept new Medicaid patients, just as you have the right to decide whether to take on new patients who aren't receiving public assistance. In your case, refusing to see new Medicaid patients seems like a reasonable decision.
We first identified all states that had not expanded Medicaid by January 2019: Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, and Wyoming.
L.A. Care Health Plan is the largest Medicaid managed care organization in the country with more than 2.5 million enrollees, according to KFF.
In all states, Medicaid provides coverage for low-income people, including families and children, pregnant women, the elderly, and people with disabilities. Some states expanded their Medicaid program to cover adults below a certain income level.
Medicaid provides health care coverage to one in five Americans — more than 70 million people — including 40% of all children and 60% of all nursing home residents. The federal and state governments jointly finance Medicaid.
25 States With the Best Medicaid Benefits
The 10 top states with the highest percentage of their populations receiving Medicaid and CHIP services are:
One likely reason fewer doctors accept Medicaid patients is that those claims are paid at a lower rate than other insurance. More providers would be interested in Medicaid if the program's reimbursements were similar to Medicare payments, according to the report.