What are the 2024 FPL income thresholds for Medicaid eligibility by state?
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Executive summary
Medicaid income eligibility is set by states as percentages of the Federal Poverty Level (FPL); in states that adopted the ACA Medicaid expansion, adults under 65 generally qualify up to 138% of the FPL, while non‑expansion states have much lower and more variable adult limits (10 states had not expanded as of May 2024) [1] [2]. Federal and expert compilations (MACPAC, KFF) list state-by-state percentages and separate rules for elderly/disabled, pregnant women, children, and special programs — but available sources do not provide a single consolidated 2024 dollar chart for every state in these search results [3] [4] [5].
1. How states set Medicaid cutoffs: a patchwork of FPL percentages
Medicaid eligibility is not a single national income number; states choose income standards expressed as percentages of the FPL and apply different rules for MAGI-based adults, children, pregnant people, and aged/disabled populations. The ACA expansion created a default adult threshold of about 138% of FPL in expansion states, but outside those states adults face widely varying, often much lower thresholds and asset tests for older or disabled applicants [1] [6] [3].
2. The expansion line: 138% FPL is the key benchmark for adults
For adults under 65 in expansion states, qualifying “by income alone” means incomes at or below roughly 138% of the FPL — the statutory 133% plus a 5% income disregard that makes the effective cutoff 138% in practice [1] [7] [8]. Multiple consumer guides and federal pages repeat this benchmark because it determines who falls into Medicaid versus Marketplace eligibility [8] [9].
3. Non‑expansion states and the coverage gap: very different adult rules
Ten states had not adopted expansion as of May 2024, leaving adults in those states subject to older, narrower eligibility categories (parents, pregnant people, disabled persons) with income limits that can be far below the expansion threshold and that often depend on household composition or dollar‑amount conversions [2] [4]. That creates the well‑known “coverage gap”: adults earning too much for traditional categorical Medicaid but below Marketplace premium credit thresholds cannot access affordable coverage in these states [9] [1].
4. Elderly and disabled applicants: FPL percentages, asset tests, and special options
Eligibility for people 65+ and those classified as disabled uses different income rules and often includes asset limits; MACPAC’s state tables compare these income‑related eligibility levels as percentages of the FPL for elderly and disabled people and document options (e.g., medically needy, 209(b) states) that raise or modify thresholds [10] [3]. Some states use dollar standards or permit “spend‑down” of medical expenses to meet eligibility [10].
5. Children and pregnant people: higher thresholds and state variability
Children and pregnant people typically qualify at higher FPL percentages than adults; thresholds for these groups vary by state and can reach multiple times the FPL in some places. Federal CHIP rules and state plans set different percentages, and MACPAC and Medicaid.gov show these distinct tables rather than a single uniform cutoff [6] [4].
6. Dollars versus percentages: converting FPL to monthly/annual income
Sources note that the FPL amounts change annually and differ for Alaska and Hawaii; some sources converted percentages into dollar amounts (for example, 2025 FPL figures appearing in state guides), but the search results here do not contain a single authoritative 2024 state-by-state dollar table — instead they point to percent‑of‑FPL tables [11] [7] [4]. For precise monthly or annual dollar thresholds you must apply the correct year’s FPL to the percentage the state uses.
7. Where to find authoritative, state‑by‑state 2024 figures
MACPAC published detailed state exhibits for 2024 that list income eligibility as percent‑of‑FPL for adults and for aged/disabled populations; KFF also compiles state indicators and is a standard resource for up‑to‑date state limits [4] [5] [3]. State Medicaid or CHIP web pages provide program‑specific dollar tables (for example, Mississippi’s site shows MAGI tables converted to dollar amounts) [12].
8. What this means if you need a number now
If you need the 2024 dollar cutoff for a given state and household size, consult (A) MACPAC’s 2024 exhibits for percent‑of‑FPL baselines [4] [3], (B) KFF’s state indicators for adult eligibility [5], and (C) your state Medicaid/CHIP website for the state’s published dollar conversions and MAGI tables [12]. Available sources do not provide a single consolidated 2024 dollar chart in these search results; hands‑on conversion from the state’s percent of FPL to the 2024 FPL dollar amounts is required [3] [4].
Limitations and competing perspectives: federal summaries present the 138% benchmark as the practical adult cutoff in expansion states [1], advocates emphasize expansion’s broad reach and uniformity [7], while state pages and MACPAC document numerous exceptions, waivers and medically needy options that complicate a simple percent threshold [4] [10]. For a definitive per‑state 2024 dollar table, use the MACPAC exhibits plus each state’s official Medicaid site; the sources here provide the framework but not a single consolidated 2024-dollar list [4] [3].