Which states plan to expand Medicaid eligibility or raise income/resource limits in 2026?
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Executive summary
Most concrete, documented 2026 changes fall into two buckets: administrative increases to state Medicaid income/resource thresholds—especially long‑term‑care caps—that many states implemented for 2026, and political campaigns and legislative efforts in a handful of non‑expansion states aiming to extend ACA-style Medicaid expansion (with Florida singled out as a 2026 target). Federal policy shifts scheduled for Jan. 1, 2026 — notably loss of the enhanced federal incentive — are changing the calculus for states considering full expansion [1] [2] [3].
1. Income and resource limits: many states raised technical thresholds for 2026
State-level rule changes that increase income or resource limits for specific Medicaid programs—most visibly the standard long‑term‑care income cap—were widely reported for 2026; one practitioner guide found “many states” nudged the long‑term‑care cap from $2,901 to $2,982 for individuals and made proportionate increases for spouses, even while asset/resource tests in most programs stayed the same [1]. This is a practical change states already implementing administratively rather than full program expansions: eligibility formulas, medically‑needy spenddowns and waiver rules still vary by state and by eligibility category [1] [4].
2. Full Medicaid expansion: a few state campaigns target 2026, but plans vary
On the question of which states “plan” to expand Medicaid eligibility in 2026, reporting shows activists and some lawmakers are explicitly targeting 2026 as the year to move ballot measures or legislation in a handful of non‑expansion states—Florida is a named priority for expansion supporters aiming at 2026, while other states have introduced or carried over expansion bills in recent sessions (Mississippi, Wisconsin, Kansas, Tennessee, Georgia, South Carolina were cited as having legislation activity) [2]. That activity indicates intent and political campaigns, not automatic enactment; outcomes depend on ballots, legislatures and governors.
3. The federal money shift in 2026 changes incentives and state calculations
A major contextual fact: analyses warn that beginning Jan. 1, 2026 federal incentives for expansion change in ways that will force states to bear a larger share of expansion costs, a factor likely to dampen some state appetite for adopting or enlarging expansion absent offsetting state revenue choices (coverage of the “OBBBA” and its elimination of the enhanced matching incentive is reported as reshaping the fiscal calculus for states in 2026) [3] [5]. This federal policy shift is an implicit political pressure point: states weighing expansion now face a different financing landscape than in the initial ACA roll‑out [3].
4. Where definitive, published state-level “plans” are thin in the available reporting
Careful catalogs of current expansion status exist (KFF and NCSL provide maps and trackers), but these sources document current adoption rather than listing an authoritative, nationwide roster of states that have officially committed to expansion in 2026; instead the record in the supplied reporting is of selective legislative efforts and administrative income‑limit increases rather than a clear, exhaustive list of states that have formally scheduled expansion to take effect in 2026 [6] [7] [1]. In short: several states increased income/resource thresholds for specific Medicaid programs in 2026, and activist/legislative campaigns in a subset of non‑expansion states (notably Florida) are targeting 2026 for full expansion, but there is no single official federal list in the provided reporting declaring which states have legally committed to expanding general Medicaid eligibility in 2026 [1] [2] [6].
5. Political and advocacy angles to watch
Advocates frame expansion as proven to lower uninsured rates and improve health outcomes—evidence summarized by the Center on Budget and Policy Priorities and KFF showing strong coverage gains in expansion states—while some state actors cite fiscal constraints and the impending change in federal matching to resist or condition expansion [8] [3]. That split defines the immediate debate: expansion backers are pursuing ballots and bills for 2026 where possible, but states facing a larger state share of costs after Jan. 1, 2026 may prefer incremental administrative eligibility tweaks (income/resource limit increases) over full expansion [2] [1] [3].