41 States Adopt Medicaid Expansion Under Affordable Care Act, 10 States Yet to Expand
As of the latest tracking, 41 states, including the District of Columbia, have adopted the Medicaid expansion provision of the Affordable Care Act (ACA). This expansion extends Medicaid coverage to nearly all adults whose incomes are up to 138% of the Federal Poverty Level, which translates to $21,597 for an individual in 2025. States that adopt this expansion receive an enhanced federal matching rate (FMAP) for their expansion populations, providing significant financial incentives. Conversely, 10 states have not yet adopted the ACA's Medicaid expansion. The status of each state is continuously monitored and analyzed by KFF, reflecting legislative actions, executive orders, and voter-led initiatives related to the expansion. This ongoing process highlights the varying approaches states are taking regarding healthcare access and federal funding opportunities under the ACA.
