The official 2027 Medicaid income limits will not be published until mid-January 2027, when the Department of Health and Human Services releases the updated federal poverty guidelines. Until then, the best available number is a projection. Based on current inflation trends, a household of one is likely to qualify for expansion Medicaid in 2027 with income up to roughly $22,690 per year (138% of the projected federal poverty level), and a household of four up to roughly $46,910 per year. These figures assume a mid-range inflation adjustment of about 3% over the confirmed 2026 guidelines. This guide breaks down the projected limits by household size, explains how the numbers are calculated, and covers the new work requirement rules that take effect January 1, 2027.
How Medicaid Income Limits Are Set
Medicaid income eligibility is tied to the federal poverty level (FPL), a set of income thresholds that HHS updates every January. In the 40 states plus Washington, D.C. that expanded Medicaid under the Affordable Care Act, adults under 65 qualify if their household income is at or below 138% of the FPL. This is the single most common Medicaid income cutoff in the country.
HHS calculates each year's poverty guidelines by taking the prior year's figures and adjusting them for inflation using the Consumer Price Index for All Urban Consumers (CPI-U). The 2026 guidelines, which took effect January 17, 2026, reflected a 2.63% increase over 2025. Because the 2027 update follows the same formula, the projected 2027 limits depend almost entirely on how much consumer prices rise through the measurement period.
Once new guidelines are published, states update their Medicaid income thresholds to match. Most do this automatically in the first quarter of the year, so 2027 figures typically go into effect for eligibility determinations by early spring 2027.
Confirmed 2026 Federal Poverty Levels (Starting Point)
Any 2027 projection has to start from the confirmed 2026 numbers. Here are the current federal poverty guidelines for the 48 contiguous states and D.C.
| Household Size | 2026 Annual FPL | 138% FPL (Medicaid Cutoff) |
|---|
| 1 | $15,960 | $22,025 |
| 2 | $21,640 | $29,863 |
| 3 | $27,320 | $37,702 |
| 4 | $33,000 | $45,540 |
| 5 | $38,680 | $53,378 |
| 6 | $44,360 | $61,217 |
| 7 | $50,040 | $69,055 |
| 8 | $55,720 | $76,894 |
| Each additional person | +$5,680 | +$7,838 |
Alaska and Hawaii use higher figures. In 2026, the FPL for one person is $19,950 in Alaska and $18,360 in Hawaii.
Projected 2027 Medicaid Income Limits
Using a mid-range inflation adjustment of 3% over the 2026 guidelines, here are the projected 2027 federal poverty levels and the corresponding 138% Medicaid income limits for expansion states. Treat these as estimates, not official figures.
| Household Size | Projected 2027 FPL | Projected 138% FPL (Medicaid) |
|---|
| 1 | $16,440 | $22,690 |
| 2 | $22,290 | $30,760 |
| 3 | $28,140 | $38,830 |
| 4 | $33,990 | $46,910 |
| 5 | $39,840 | $54,980 |
| 6 | $45,690 | $63,050 |
| 7 | $51,540 | $71,130 |
| 8 | $57,390 | $79,200 |
These annual limits translate to roughly $1,891 per month for one person and $3,909 per month for a family of four at the 138% threshold.
Why the Numbers Are a Range, Not a Fact
Inflation is the only real variable here, so it helps to see how the projection shifts under different scenarios. The table below shows the projected 138% FPL Medicaid cutoff for a household of one and a household of four under low, mid, and high inflation assumptions.
| Inflation Scenario | Household of 1 | Household of 4 |
|---|
| Low (2%) | $22,465 | $46,451 |
| Mid (3%) | $22,690 | $46,910 |
| High (4%) | $22,905 | $47,362 |
The spread between the low and high scenarios is only a few hundred dollars, which is why a 3% mid-range estimate is a reasonable working number. As of mid-2026, CPI-U trends line up most closely with the mid-range case. If inflation cools before the measurement window closes, the final 2027 limits could land nearer the low end.
Medicaid Limits Beyond the 138% Adult Group
The 138% cutoff applies to the ACA expansion adult group, but Medicaid uses different income thresholds for other populations. These groups will also see their limits rise with the 2027 FPL update.
- Children (CHIP and Medicaid): Many states cover children up to 200% to 300% of the FPL or higher, depending on the state.
- Pregnant individuals: Coverage commonly extends to 138% to 200%+ of the FPL, with some states going higher.
- Aged, blind, and disabled (ABD): These pathways often tie to the Supplemental Security Income (SSI) limit rather than a straight FPL percentage.
- Non-expansion states: In the 10 states that have not expanded Medicaid, income limits for adults are far lower and often exclude childless adults entirely, creating a coverage gap.
Because each state sets its own thresholds within federal rules, the 2027 income limit for your household depends on which eligibility group you fall into and where you live.
The Bigger 2027 Change: Work Requirements
For 2027, the projected income limits are only part of the story. Under the 2025 federal budget reconciliation law (commonly called the One Big Beautiful Bill Act), states must implement Medicaid work requirements for the ACA expansion adult group starting January 1, 2027.
Here is what the rule requires for adults ages 19 to 64 in the expansion group:
- Complete at least 80 hours per month of work, community service, or a qualifying work program.
- Or be enrolled at least half-time in an educational program.
- Or earn at least the equivalent of 80 hours per month at the federal minimum wage (about $580 per month).
- Or qualify for an exemption.
Exemptions apply to pregnant individuals, people who are medically frail, those receiving disability benefits, full-time students, and caregivers of children under 13, among others. Nebraska became the first state to implement the new requirements on May 1, 2026, ahead of the federal deadline.
The Congressional Budget Office projects that about 18.5 million people will be subject to the work requirement, and that roughly 5.2 million could lose Medicaid coverage as a result, largely due to paperwork and reporting hurdles rather than actual ineligibility. This matters because in 2027, meeting the income limit alone may not be enough to keep coverage. You will also need to document work activity or an exemption in most expansion states.
How to Check Whether You Qualify
If your income is near the projected 2027 threshold, a few practical steps can help you confirm eligibility.
- Confirm your household size. Medicaid counts you, your spouse, and tax dependents. A larger household means a higher income limit.
- Calculate your MAGI. Medicaid uses Modified Adjusted Gross Income, which is close to your adjusted gross income with a few add-backs. Most wage income counts; some benefits do not.
- Compare against 138% of the FPL for your household size using the projected table above, then verify against the official 2027 figures once they publish in January 2027.
- Check your state's expansion status. If you live in a non-expansion state, the adult limit is much lower and different rules apply.
- Prepare for work requirement documentation if you are an expansion adult, since verification begins in 2027.
Even if your income is slightly above the Medicaid cutoff, you may qualify for subsidized ACA marketplace coverage instead, which uses the same FPL as its baseline.
Frequently Asked Questions
What will the 2027 Medicaid income limit be for a single person?
The projected 2027 Medicaid income limit for a household of one in an expansion state is approximately $22,690 per year, or about $1,891 per month, based on 138% of a mid-range projected federal poverty level. The official figure will be confirmed when HHS releases the 2027 poverty guidelines in mid-January 2027.
When will the official 2027 Medicaid income limits be published?
HHS publishes updated federal poverty guidelines each January in the Federal Register. The 2026 guidelines took effect January 17, 2026, so the 2027 numbers are expected in mid-January 2027. State Medicaid agencies typically apply the new limits within the first few months of the year.
How is the 2027 projection calculated?
The projection applies an estimated inflation adjustment to the confirmed 2026 poverty guidelines. HHS uses the Consumer Price Index for All Urban Consumers (CPI-U) to set the annual increase. The 2026 update was 2.63%. A mid-range assumption of about 3% produces the projected 2027 figures shown above.
Does a higher income limit mean more people will qualify in 2027?
Not necessarily. While the income limits are projected to rise with inflation, the new work requirements taking effect January 1, 2027 could reduce enrollment. The CBO estimates roughly 5.2 million people could lose coverage due to the work rules, even if their income still falls under the limit.
What is 138% of the federal poverty level?
138% of the FPL is the standard Medicaid income cutoff for adults in the 40 states and D.C. that expanded Medicaid under the ACA. It equals the federal poverty level for your household size multiplied by 1.38. For 2026, that is $22,025 for one person and $45,540 for a family of four.
Do work requirements apply to everyone on Medicaid in 2027?
No. The 2027 work requirements apply to the ACA expansion adult group, ages 19 to 64. Pregnant individuals, medically frail people, disability benefit recipients, full-time students, and caregivers of children under 13 are among those exempt. Children, seniors, and people in long-term care programs are not subject to the rule.
The Bottom Line
The projected 2027 Medicaid income limit is roughly $22,690 per year for one person and $46,910 for a family of four in expansion states, assuming a mid-range 3% inflation adjustment. Those numbers will firm up when HHS publishes the official 2027 poverty guidelines in January 2027. The larger shift for 2027 is the new work requirement, which means qualifying on income alone may not be enough to keep coverage in expansion states. If your income is near the threshold, it is worth confirming your household size, calculating your MAGI, and understanding your state's rules before the changes take effect.
