What new income or asset thresholds for Medicaid take effect in 2026 and how do they vary by state?
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
Federal and state-level Medicaid thresholds shift for 2026 in two clear ways: many long‑term care income limits track the Federal Benefit Rate (FBR) and cluster around $2,982/month for single applicants (300% of the FBR) while the ACA expansion and most MAGI‑based adult eligibility remains tied to 138% of the Federal Poverty Level (FPL) [1] [2]. States vary widely on asset tests: most long‑term care programs still use a $2,000 individual resource limit, but California has reinstated a $130,000 Medi‑Cal asset cap for non‑MAGI programs effective Jan. 1, 2026, and New York and other states set much higher or different amounts [3] [4] [5].
1. Two different measurement systems — FPL for MAGI adults, FBR for many long‑term care rules
Medicaid eligibility uses different yardsticks depending on the population. For MAGI‑based adults (children, parents, most adults under expansion) the threshold is a percentage of the Federal Poverty Level — the ACA expansion functions as about 138% FPL in practice [6] [2]. For institutional and many Home and Community‑Based Services (HCBS) long‑term care programs, most states tie income caps to multiples of the Federal Benefit Rate: the dominant group will use 300% of the FBR, which yields an individual threshold of about $2,982/month in 2026 [1].
2. 2026 headline income figures you will see repeatedly
Expect to see two headline numbers in state charts: the expansion/MAGI cutoff near 138% of FPL for adults in expansion states (calculated using the latest available FPL guidance) and a roughly $2,982/month income limit for single applicants in many long‑term care contexts where states use 300% of the FBR [2] [1]. Coverage determinations still vary by household size, program type, and whether the state applies disregards or different program‑specific rules [7].
3. Asset tests: most states remain strict, but California and a few others diverge
While many states maintain the traditional $2,000 countable asset ceiling for single applicants in nursing‑home/HCBS Medicaid, several notable exceptions exist. California reinstated a non‑MAGI Medi‑Cal asset limit of $130,000 for an individual (and $195,000 for couples) effective January 1, 2026 following budget negotiations [4] [8]. New York and Illinois also show higher long‑term care resource limits (e.g., NY $32,396, Illinois $17,500 cited as exceptions), underscoring that asset limits are highly state‑specific [3] [5].
4. What this means for people planning care or applying in 2026
If you’re applying for institutional Medicaid or HCBS, countable income and assets determine eligibility in addition to medical need; exceeding the income cap in nursing home cases often means nearly all income goes to care, leaving only a small personal needs allowance [9] [10]. Asset rules can force dramatic planning decisions: California’s reinstated cap will prompt re‑evaluations of estate transfers, gift timing, and spousal protections for those nearing the new Medi‑Cal threshold [11] [12].
5. Where states vary most and why — home equity, spousal protections and “medically needy” pathways
States exercise discretion on home equity limits (federal minimum/maximum ranges apply), Community Spouse Resource Allowances (CSRA) and on whether they offer medically needy or spend‑down pathways for people whose incomes exceed program caps [13] [5] [9]. For example, federal home equity interest limits in 2026 generally run between about $752,000 and $1,130,000 and states choose within that band, affecting whether a home counts as an asset [13]. Spousal impoverishment protections and the MMMNA also change how household income is allocated [10].
6. Policy drivers and competing perspectives in the 2026 changes
States that tightened asset rules (notably California) framed their moves as budget discipline; advocates warn reinstated limits will cut coverage and force hard planning choices for older adults and people with disabilities [8] [11]. At the same time, many providers and planners point to the FBR‑based increases as routine indexing rather than policy expansions [1]. Sources differ in tone: government‑oriented guides stress that thresholds reflect standard federal updates, while advocacy and planning outlets highlight the real‑world hardship of stricter asset tests [7] [8].
7. Practical next steps and limits of available reporting
If you or a loved one may need Medicaid in 2026, check your state’s official Medicaid website for program‑specific income and asset tables and prepare for redeterminations and documentation requests [14]. Available sources do not mention a single uniform 2026 national table covering every state program; state variation is substantive and program‑by‑program (not found in current reporting). For complex situations, certified Medicaid planners or elder law attorneys can quantify the impact of the 2026 FBR and state asset rules on eligibility [1] [11].
Limitations: this summary relies on state planning guides, Medicaid‑planning organizations, and state notices in the provided reporting; exact monthly dollar cutoffs and household formulas differ by state and program and must be verified on each state Medicaid site [14] [15].