As of early 2026, 10 states have not adopted the Affordable Care Act (ACA) Medicaid expansion, which would provide coverage to nearly all low-income adults with incomes up to 138% of the federal poverty level. These states, where a "coverage gap" exists for many low-income residents, are:
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.
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.
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 ...
What is Medicaid called in your state?
Vermont, Utah and Minnesota topped the Commonwealth Fund's Medicare performance scorecard in 2025, whereas Kentucky, Mississippi and Louisiana struggled the most.
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.
Each state decides who can get Medicaid and if they can help more people. States usually cover older people, children, pregnant woman and people with disabilities.
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.
In many areas, finding Medicaid providers can be difficult. Medicaid's payment rates are lower than Medicare's or other insurance and may drive some providers away from treating patients with Medicaid coverage.
The worst, in order from 50th to 41st, are in Mississippi, Idaho, Texas, Oklahoma, South Dakota, Indiana, South Carolina, Colorado, Alabama, and Missouri.
The Affordable Care Act, also known as Obamacare, was enacted in 2010, but 10 states have not expanded Medicaid, the federal-state program that provides health care for low-income people. They are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.
Here are some of the biggest Medicare mistakes to avoid: