No, Florida has not expanded Medicaid under the Affordable Care Act. It is one of 10 states that still limit coverage to specific categories of residents instead of opening eligibility to all low-income adults up to 138 percent of the federal poverty level. The practical effect is severe: a parent in Florida generally must earn less than about 27 percent of the federal poverty level to qualify, and childless adults under 65 without a disability usually cannot qualify at any income.
Why Florida Hasn’t Expanded
The ACA originally required every state to extend Medicaid to adults earning up to 138 percent of poverty. In 2012, the U.S. Supreme Court ruled in National Federation of Independent Business v. Sebelius that Congress could not force states to expand, which made the decision voluntary. Florida’s legislature and governor have repeatedly declined, keeping the traditional eligibility categories set out in Chapter 409 of the Florida Statutes.1Florida Legislature. Florida Statutes 409 – Social and Economic Assistance
An advocacy group called Florida Decides Healthcare is working to put expansion on the 2028 statewide ballot. The group originally aimed for 2026 but shifted after a 2025 state law tightened the rules on petition drives, and it has filed a legal challenge to that law. As of early 2026, expansion remains an open political question with no guaranteed outcome, so the eligibility rules below are what applies today.
Who Still Qualifies for Medicaid in Florida
Because Florida did not expand, you have to fit one of the traditional categories and meet the financial test for that category. Low income by itself is not enough.
Pregnant Women
Pregnant women qualify with household income up to 196 percent of the federal poverty level — roughly $3,456 a month for a household of two in 2026.2Florida Department of Children and Families. Determining Your Income Limit Coverage continues through 60 days postpartum.
Children
Children’s thresholds depend on age. Infants under one qualify up to about 206 percent of poverty, with lower thresholds for ages one through five and six through 18.2Florida Department of Children and Families. Determining Your Income Limit Families who earn too much for Medicaid may still qualify for Florida KidCare, the state’s Children’s Health Insurance Program. Since January 2024, federal law requires 12 months of continuous eligibility for children under 19, so a child enrolled in Medicaid or CHIP stays covered for the full year even if family income rises.3Medicaid.gov. Continuous Eligibility for Medicaid and CHIP Coverage
Parents and Caretaker Relatives
Parents and caretaker relatives face the strictest income limits in the state, capped at roughly 27 percent of the federal poverty level. That works out to about $476 a month for a family of two or $598 for a family of three.2Florida Department of Children and Families. Determining Your Income Limit These are among the lowest parent thresholds in the country, and they are a direct consequence of not expanding.
Seniors and People With Disabilities
Adults 65 and older and people with qualifying disabilities can receive Medicaid if they meet Supplemental Security Income standards. For most applicants, countable assets cannot exceed $2,000 for a single person. Your primary home, one vehicle, personal belongings, and certain burial funds are excluded. Income limits are tied to the SSI federal benefit rate.
For long-term care coverage such as a nursing home, Florida also applies a home equity cap. As of 2026, you can have up to $752,000 in home equity and still qualify. That limit does not apply if your spouse, a child under 21, or a blind or disabled child of any age lives in the home.
The Medically Needy Program
If your income is too high for regular Medicaid but you have large medical bills, Florida’s Medically Needy program — often called “Share of Cost” — may help. It works like a monthly deductible: you have to incur a set amount of medical expenses each month before Medicaid picks up the rest for that month. The spend-down amount depends on household size and income. This pathway matters most for seniors and people with disabilities whose income slightly exceeds the SSI-related limits.
Who Does Not Qualify
Non-disabled adults under 65 without dependent children generally cannot qualify for Florida Medicaid at any income level. In an expansion state, these adults would be covered up to 138 percent of poverty. In Florida, there is no category for them.
The Coverage Gap
The clearest consequence of Florida’s decision is the “coverage gap.” These are adults who earn too much to meet Florida’s narrow Medicaid categories but too little to receive premium tax credits on the federal Health Insurance Marketplace. Marketplace subsidies begin at 100 percent of the federal poverty level, which is $15,960 a year for a single person in 2026.4HealthCare.gov. Medicaid Expansion and What It Means for You5ASPE – HHS.gov. 2026 Poverty Guidelines – 48 Contiguous States An adult earning below that threshold in Florida often has no affordable coverage option at all.
The gap mainly affects non-disabled adults under 65 without dependent children. It also catches some parents whose income falls between the roughly 27-percent-of-poverty parent ceiling and the 100-percent-of-poverty floor for Marketplace subsidies. Nationally, nearly 2 million adults across the 10 non-expansion states are estimated to be in this coverage gap.
What to Do If You’re in the Gap
Check the Marketplace Even If You Think You Can’t Afford It
If your projected annual income is at or above 100 percent of the federal poverty level — $15,960 for a single person in 2026 — you can shop for coverage through HealthCare.gov. Premium tax credits lower your monthly cost based on income and household size, and cost-sharing reductions can lower what you pay for doctor visits and prescriptions.6HealthCare.gov. Federal Poverty Level (FPL) – Glossary Open enrollment typically runs from November through mid-January, and qualifying life events such as losing coverage, moving, or having a baby allow enrollment outside that window. Many people in the gap discover that part-time work or self-employment income puts them just over the 100 percent line, which actually opens the door to subsidized Marketplace coverage.
Federally Qualified Health Centers
If no insurance option works, Federally Qualified Health Centers (FQHCs) provide primary care, dental care, mental health services, and prescription assistance regardless of ability to pay. These clinics receive federal funding and charge on a sliding fee scale based on household income.7Health Resources and Services Administration. Chapter 9 – Sliding Fee Discount Program Patients at or below the federal poverty level typically pay little or nothing. You can find a center near you through the HRSA health center finder at findahealthcenter.hrsa.gov.
Apply Anyway If You Think You Might Qualify
If any category above fits you — pregnancy, a child in the home, age 65 or older, a disability, or large current medical bills — apply through the Department of Children and Families MyACCESS portal.8Florida Department of Children and Families. MyACCESS Portal Information Florida Medicaid eligibility can currently be backdated up to three months before your application date, so if you were hospitalized or incurred large bills recently and would have qualified at the time, those costs can be covered retroactively.9eCFR. 42 CFR 435.915 – Effective Date Under the One Big Beautiful Bill Act signed in July 2025, that retroactive window shrinks from three months to two months for traditional Medicaid enrollees starting January 1, 2027, so applying sooner protects more of your past bills.