Non-disabled childless adults are not included in the categories of people states can cover through Medicaid under current federal rules, regardless of their income. As such, states can only provide coverage to low-income childless adults through a Medicaid waiver or a fully state-funded program. This table reflects income eligibility limits as a percent of the federal poverty level for waiver and state-funded programs for childless adults that provide direct coverage or premium subsidies. It does not reflect other state coverage strategies such as purchasing pools, reinsurance programs, or changes in insurance market regulations.

A program is categorized as having a “More Limited Benefit Package” if it provides more limited benefits and/or charges higher cost sharing than the state provides to parents covered through its regular Medicaid program. The scope of coverage and the levels of enrollment in these programs vary widely across states. For further state-specific details see http://www.kff.org/medicaid/7900.cfm.

Expanding Health Coverage for Low-Income Adults: Filling the Gaps in Medicaid Eligibility. KCMU analysis of state policies through program websites and contacts with state officials, April 2009. Available at http://www.kff.org/medicaid/7900.cfm.

Enrollment Closed: Enrollment in the program is closed to new applicants as of April 2009.

Employment Requirement: Eligibility for the program is limited to individuals who work for specified qualified employers or meet other employment-related eligibility requirements.

NA: State does not provide a waiver or state-funded coverage to childless adults.

1. The program is financed solely with state dollars.
2. Childless adults up to 100% FPL are eligible for a more limited benefit package under the MaineCare waiver program. Additionally, the state offers a fully state-funded subsidized coverage plan, called Dirigo Health, to parents and childless adults up to 300% of poverty.
3. Childless adults up to 100% FPL are eligible for a more limited benefit package under the OHP Standard waiver program, and the state provides premium assistance to parents and childless adults up to 185% FPL through the Family Health Insurance Assistance Program (FHIAP).
4. The state offers a subsidized limited coverage plan, called CoverTN, to workers of qualified businesses, self-employed individuals, and recently unemployed workers earning (or who earned) up to $55,000 per year. For businesses to qualify, at least 50% of employees must earn $55,000 or less per year. Once a business qualifies, all eligible employees, regardless of income may enroll. Eligible local county governments and their employees may also enroll as well as spouses of enrollees.