The American healthcare system continues to evolve, and 2025 witnesses sweeping change arrive on Medicaid—the publicly funded health coverage for low-income Americans. As part of the ongoing efforts to expand access to healthcare, various states are opening up their Medicaid programs or revising eligibility requirements to cover more individuals and families.
In this article, we’ll cover everything you need to know about 2025 Medicaid expansion, such as:
- Who is eligible for Medicaid today
- Which states are adding coverage
- How to apply or become eligible
- The advantages of participating in the Medicaid program
What Is Medicaid?
Medicaid is a state-federal health insurance program for:
- Low-income families and individuals
- People with disabilities
- Pregnant women
- Children and adults who need long-term care
Each state administers its own program with regulations implemented by the Centers for Medicare & Medicaid Services (CMS).
What’s Changing in 2025?
To 2025, the government has continued offering incentives to states that choose to expand Medicaid coverage under the Affordable Care Act (ACA). Several states that previously rejected expansion are now reconsidering due to:
- Growing healthcare costs
- Pressure from local authorities and health activists
- Chances to reduce citizens without health insurance
States Expanding Medicaid in 2025
Through April 2025, the following states have announced plans to expand Medicaid or are doing so:
| State | Expansion Status | Expected Implementation |
|---|
| Texas | Newly Approved | July 2025 |
| Florida | Under Review | TBD |
| Georgia | Partial Expansion | October 2025 |
| Mississippi | Approved with Waiver | September 2025 |
| South Carolina | Considering Expansion | 2026 |
| Wyoming | Expansion Begins | August 2025 |
These expanded coverage could extend healthcare coverage to millions more Americans who previously were in a coverage gap.
Medicaid Eligibility Requirements in 2025
Income-Based Eligibility
It is largely based on family income relative to the Federal Poverty Level (FPL). In expansion states, it ranges as follows:
- 138% of FPL for non-disabled individuals under 65 years old
- That’s around $20,783/year for one adult
- Or $35,631/year for a household of 3
Other Factors
- Residence state
- U.S. citizenship or lawful residency
- Age (children and seniors might have varying limits)
- Pregnancy or disability status
Utilize the Healthcare.gov Medicaid calculator to verify your individual eligibility.
What Are the Benefits of Medicaid?
Medicaid provides a wide array of essential health care services at little or no cost. Benefits commonly include:
- Annual checkup and visits with the doctor
- Hospital stays
- Lab work and X-rays
- Mental health and alcohol and drug abuse treatment
- Prescription medicine
- Long-term care for disabled or older people
- Preventive care such as cancer screenings and vaccines
Your state can also offer services like dental or vision care.
How to Apply for Medicaid in 2025
You may apply:
Online:
- via your state’s Medicaid website
- Through Healthcare.gov
In Person:
- At your local Medicaid office
- At participating hospitals or clinics
By Phone or Mail:
- Most states provide toll-free hotline lines and downloadable applications.
Pro tip: Have your income paperwork, Social Security number, and ID handy when applying.
Common Myths About Medicaid
“I make too much to qualify.”
With expanded coverage, more low-to-moderate income workers qualify—even if they’re not considered “poor.”
“I have to be unemployed.”
Many working adults with lower incomes are eligible, particularly in expansion states.
“Medicaid is just for those with children.”
Expansion includes childless adults up to 138% FPL in most states.
Medicaid Coverage Snapshot – 2025
| Group | Coverage Rate (%) |
|---|
| Children | 93% |
| Working Adults | 74% |
| Pregnant Women | 89% |
| Elderly & Disabled | 100% (if qualified) |
States’ Benefits of Expansion
Medicaid expansion states typically report:
- Reduced hospital uncompensated care costs
- Lower uninsured rates
- Better health status among low-income individuals
- Economic benefits from federal matching funds
FAQ’s
Q. What is Medicaid expansion?
A. Medicaid expansion enables additional individuals to become eligible for the program by increasing income thresholds and eliminating some previous restrictions.
Q. Which states are expanding Medicaid in 2025?
A. States such as Texas, Georgia, and Mississippi are either expanding or changing Medicaid coverage this year.
Q. Can I be eligible for Medicaid if I am employed?
A. Yes! Lots of working adults are eligible under the higher income limits.