Healthcare Access

States Without Obamacare Exchanges 2025

Medicaid Expansion (Obamacare) Status 2024

Adopted and Implemented
Not Adopted
State
Medicaid Expansion (Obamacare) Status 2024
Date Implemented
Additional Details
Alabama Flag
AlabamaNot Adopted
Florida Flag
FloridaNot Adopted
Georgia Flag
GeorgiaNot Adopted
Kansas Flag
KansasNot Adopted
Mississippi Flag
MississippiNot Adopted
South Carolina Flag
South CarolinaNot Adopted
Tennessee Flag
TennesseeNot Adopted
Texas Flag
TexasNot Adopted
Wisconsin Flag
WisconsinNot Adopted
Wyoming Flag
WyomingNot Adopted
Alaska Flag
AlaskaAdopted and ImplementedSeptember 1, 2015
Arizona Flag
ArizonaAdopted and ImplementedJanuary 4, 2014
Arkansas Flag
ArkansasAdopted and ImplementedJanuary 4, 2014
California Flag
CaliforniaAdopted and ImplementedJanuary 4, 2014
Colorado Flag
ColoradoAdopted and ImplementedJanuary 4, 2014
Connecticut Flag
ConnecticutAdopted and ImplementedJanuary 4, 2014
Delaware Flag
DelawareAdopted and ImplementedJanuary 4, 2014
District of Columbia Flag
District of ColumbiaAdopted and ImplementedJanuary 4, 2014
Hawaii Flag
HawaiiAdopted and ImplementedJanuary 4, 2014
Idaho Flag
IdahoAdopted and ImplementedJanuary 1, 2020
Illinois Flag
IllinoisAdopted and ImplementedJanuary 4, 2014
Indiana Flag
IndianaAdopted and ImplementedFebruary 1, 2015
Iowa Flag
IowaAdopted and ImplementedJanuary 4, 2014
Kentucky Flag
KentuckyAdopted and ImplementedJanuary 4, 2014
Louisiana Flag
LouisianaAdopted and ImplementedJuly 1, 2016
Maine Flag
MaineAdopted and ImplementedJanuary 10, 2019With coverage retroactive to July 2, 2018
Maryland Flag
MarylandAdopted and ImplementedJanuary 4, 2014
Massachusetts Flag
MassachusettsAdopted and ImplementedJanuary 4, 2014
Michigan Flag
MichiganAdopted and ImplementedApril 1, 2014
Minnesota Flag
MinnesotaAdopted and ImplementedJanuary 4, 2014
Missouri Flag
MissouriAdopted and ImplementedOctober 1, 2021
Montana Flag
MontanaAdopted and ImplementedJanuary 1, 2016With coverage retroactive to July 1, 2021
Nebraska Flag
NebraskaAdopted and ImplementedOctober 1, 2020
Nevada Flag
NevadaAdopted and ImplementedJanuary 4, 2014
New Hampshire Flag
New HampshireAdopted and ImplementedAugust 15, 2014
New Jersey Flag
New JerseyAdopted and ImplementedJanuary 4, 2014
New Mexico Flag
New MexicoAdopted and ImplementedJanuary 4, 2014
New York Flag
New YorkAdopted and ImplementedJanuary 4, 2014
North Carolina Flag
North CarolinaAdopted and ImplementedDecember 1, 2023
North Dakota Flag
North DakotaAdopted and ImplementedJanuary 4, 2014
Ohio Flag
OhioAdopted and ImplementedJanuary 4, 2014
Oklahoma Flag
OklahomaAdopted and ImplementedJuly 1, 2021
Oregon Flag
OregonAdopted and ImplementedJanuary 4, 2014
Pennsylvania Flag
PennsylvaniaAdopted and ImplementedJanuary 1, 2015
Rhode Island Flag
Rhode IslandAdopted and ImplementedJanuary 4, 2014
South Dakota Flag
South DakotaAdopted and ImplementedJuly 1, 2023
Utah Flag
UtahAdopted and ImplementedJanuary 1, 2020
Vermont Flag
VermontAdopted and ImplementedJanuary 4, 2014
Virginia Flag
VirginiaAdopted and ImplementedJanuary 1, 2019
Washington Flag
WashingtonAdopted and ImplementedJanuary 4, 2014
West Virginia Flag
West VirginiaAdopted and ImplementedJanuary 4, 2014
  • As of April 2024, all 50 states, Puerto Rico and the District of Columbia have access to health insurance marketplaces under the Affordable Care Act (ACA), also known as Obamacare Exchanges.
  • Medicaid is a joint federal and state program that provides health insurance coverage to low-income adults, children, pregnant women, seniors, and people with disabilities in the United States.
  • Before Medicaid: Limited eligibility for adults, primarily focused on specific populations (children, pregnant women, seniors, people with disabilities).
  • Medicaid Expansion: Increased eligibility for adults with incomes up to 138% of the FPL (optional for states).