Medicaid Gap Check

Medicaid Coverage Gap Calculator

Find out if you fall into the coverage gap — and what options you have for health insurance in 2026.

⚠ī¸ Texas has NOT expanded Medicaid — coverage gap risk

2026 FPL for 1-person household: $15,650

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Enter your state, household size, and income to see your result.

Income Brackets for 1-Person Household (2026)

Under 100% FPLUnder $15,650/yr

⚠ī¸ Coverage gap — no subsidies available

100% – 138% FPL$15,650 – $21,597/yr

💰 Marketplace subsidies available

138% – 250% FPL$21,597 – $39,125/yr

💰 Strong subsidies + Cost-Sharing Reductions on Silver plans

250% – 400% FPL$39,125 – $62,600/yr

💰 Subsidies available — watch the 400% cliff

Above 400% FPLOver $62,600/yr

ℹī¸ No ACA subsidies — full premium applies

What Is the Medicaid Coverage Gap?

The gap explained: The ACA was designed so that Medicaid would cover everyone below 100% FPL, and marketplace subsidies would cover 100–400% FPL. But the Supreme Court made Medicaid expansion optional for states.

The result: In states that declined expansion, adults earning below 100% FPL fall into a gap — too high for traditional Medicaid, too low for marketplace subsidies. An estimated 1–2 million Americans are affected.

Non-expansion states as of 2026: Texas, Florida, Georgia, Alabama, Mississippi, Tennessee, South Carolina, Kansas, Wisconsin, and Wyoming remain the primary holdouts.

Expansion states: If your state expanded Medicaid, adults up to 138% FPL are covered. You are NOT in the gap.

Estimate My Subsidy →Texas Coverage Guide →

Based on 2026 FPL guidelines. Results are estimates for educational purposes only — not tax or insurance advice. Medicaid eligibility depends on additional factors. Verify with your state Medicaid office or HealthCare.gov.