Medicaid redeterminations in 2026 look very different from prior years. Before COVID, states renewed Medicaid eligibility annually as a standard administrative cycle. During the pandemic, the federal government halted redeterminations through continuous enrollment provisions. After those ended in 2023 and 2024, states worked through a large backlog of renewals known as the Medicaid Unwinding. In 2026, the One Big Beautiful Bill Act (OBBBA) added new layers: expansion adults ages 19 to 64 without disabilities must now prove they meet work requirements (in states implementing them), and starting December 31, 2026, renewals for expansion adults will happen every six months instead of annually. Nebraska began enforcing work requirements May 1, 2026. Montana and Iowa plan enforcement by end of 2026. All states must comply by January 1, 2027. The result is that more Medicaid enrollees are receiving redetermination notices in 2026 than in any previous year, and a larger share of those notices result in terminations because the rules are stricter. If your Medicaid was terminated, that termination triggers a Special Enrollment Period at healthcare.gov that gives you 90 days to find new coverage. Most people who lose Medicaid at redetermination can access ACA Marketplace plans with subsidized premiums, often at $0 to $150 per month after premium tax credits.
State redetermination timelines in 2026 vary significantly. Some states send 30-day advance notices before coverage ends; others send 60-day notices. State Medicaid agencies use different portals, different appeal deadlines, and different document requirements. The table in this guide shows the current redetermination cycle, renewal portal, and appeal deadline for each state, so you can act in the right order: verify your state's schedule, check your income against the 2026 Medicaid income limits, appeal if the termination was wrong, and simultaneously apply for Marketplace coverage through healthcare.gov if your income is above 138% FPL. For state Medicaid eligibility by income and household size, the Medicaid income limits page provides the full 50-state lookup. For ACA subsidy thresholds, the ACA income limits page shows the 2026 cliff and credit ranges. The ACA subsidy cliff returned for 2026 after enhanced premium tax credits from ARPA and the IRA expired January 1, 2026, so people above 400% FPL ($63,840 for a single person in 2026) no longer receive any ACA subsidy.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The most costly mistakes people make after losing Medicaid at a 2026 redetermination:
- Waiting on the appeal before applying to the Marketplace. Medicaid appeals take weeks or months. Apply to healthcare.gov on the same day you file your appeal. If your appeal succeeds, you can cancel the Marketplace plan; if it fails, you have coverage and have not lost time.
- Missing the 90-day SEP window. Unlike the standard 60-day SEP for most coverage losses, Medicaid loss gives you 90 days. But the clock starts on the termination date, not when you read the notice. A notice dated June 1 with a termination date of July 1 means your 90-day window ends September 28.
- Using last year's income instead of projected 2026 income. ACA subsidies are calculated on projected current-year Modified Adjusted Gross Income (MAGI). If your income dropped since last year, your current projected income is lower and your subsidy is larger. Report what you expect to earn the rest of 2026.
- Not checking whether income still qualifies for Medicaid re-enrollment. Many 2026 terminations are based on data-matching discrepancies, not actual income over the limit. Re-apply with current documentation; if your income is genuinely under 138% FPL, Medicaid enrollment is year-round and free.
- Enrolling children in a Marketplace family plan without checking CHIP first. Children at incomes up to 200% to 300% FPL often qualify for CHIP, which has lower out-of-pocket costs than an ACA Marketplace plan. Check your state's CHIP program before adding children to a Marketplace plan.
- Choosing a short-term health plan to save money. Short-term plans are not ACA-compliant, can deny coverage for pre-existing conditions, and do not satisfy the qualifying coverage requirement that ends a gap. An ACA Silver plan with subsidies is almost always a better option for people between 138% and 400% FPL.
State-by-State Medicaid Redetermination Portals, Renewal Cycles, and Appeal Deadlines (2026)
State Medicaid redetermination processes differ widely in 2026. The portal you use, the advance notice you receive before termination, and your appeal rights all depend on your state. The following state reference covers the major portal URLs, the current renewal cycle under OBBBA rules, and the standard appeal window. Annual renewal states send one letter per year; semi-annual renewal states (required for expansion adults by December 31, 2026) send two. Check your state agency for the most current information, as OBBBA implementation timelines were still being finalized as of June 2026.
Expansion states (40 states plus DC) use income at 138% FPL as the primary cutoff for non-disabled adults. Non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming) have much stricter income limits for adults, typically covering only parents with children at very low incomes and people with qualifying disabilities. In non-expansion states, most adults losing Medicaid have limited appeal options and Marketplace coverage is the primary alternative. State Medicaid programs use branded names: California's Medi-Cal renews through the BenefitsCal portal; Arizona's AHCCCS uses the HEAplus portal; Washington's Apple Health uses the Washington Healthplanfinder; Massachusetts's MassHealth uses the Health Connector; New Jersey's NJ FamilyCare uses the NJ FamilyCare portal; Connecticut's HUSKY Health uses the AccessHealthCT portal. Find your state portal via the Medicaid.gov directory of state websites.
Selected State Medicaid Portals and Renewal Information, 2026| State | Program brand | Renewal portal | Appeal window |
|---|
| California | Medi-Cal | BenefitsCal (benefitscal.com) | 90 days from notice |
| Texas | Texas Medicaid | YourTexasBenefits (yourtexasbenefits.com) | 90 days from notice |
| Florida | Florida Medicaid | ACCESS Florida (myflorida.com/accessflorida) | 90 days from notice |
| New York | NY Medicaid / Essential Plan | NY State of Health (nystateofhealth.ny.gov) | 60 days from notice |
| Arizona | AHCCCS | HEAplus (healplus.az.gov) | 30 days from notice |
| Massachusetts | MassHealth | MassHealth online portal (mass.gov/masshealth) | 30 days from notice |
| Washington | Apple Health | Washington Healthplanfinder (wahealthplanfinder.org) | 90 days from notice |
| Wisconsin | BadgerCare Plus | ACCESS Wisconsin (access.wi.gov) | 45 days from notice |
| Nebraska | Heritage Health / Nebraska Medicaid | ACCESSNebraska (myaccessnebraska.com) | 30 days from notice |
| New Jersey | NJ FamilyCare | NJ FamilyCare portal (njfamilycare.org) | 45 days from notice |
Appeal deadlines vary; always check your specific termination notice for the deadline that applies to you. Most states allow appeals up to 90 days from the notice date, but some are shorter. If you appeal before your coverage ends, you may receive continuation of benefits during the appeal process.
Source: State Medicaid agency websites and Medicaid.gov state directory, accessed June 2026
The 2026 OBBBA Work Requirements: Who Is Affected and Who Is Exempt
Work requirements under the One Big Beautiful Bill Act (OBBBA), signed July 4, 2025, are the most significant change to Medicaid eligibility since ACA expansion. Starting with Nebraska's implementation May 1, 2026, expansion adults ages 19 to 64 who are not exempt must document at least 80 hours per month of qualifying activity: employment, job training, job search, education, volunteering, or caregiving for a family member. Failure to document these hours triggers a Medicaid termination that then starts the 90-day Marketplace SEP clock. Not everyone is subject to work requirements. Federal exemptions that states must honor include: people with a disability or serious medical condition documented by a physician; pregnant women or people who gave birth in the last 60 days; primary caregivers of a child under 14 or a disabled adult; full-time students enrolled at least half-time; people 65 or older; people receiving other income supports (SSI, SSDI, TANF); and people experiencing homelessness or domestic violence. Document your exemption category before a redetermination notice arrives. If your termination cites work requirements and you believe you are exempt, file the appeal immediately with the supporting documentation.
OBBBA also reduces Medicaid retroactive coverage for expansion adults starting January 1, 2027. Currently, Medicaid can cover medical bills for up to 3 months before your application date. Under OBBBA, that retroactive window shrinks to 1 to 2 months for expansion adults beginning in 2027. The change does not affect retroactive coverage for children or pregnant women. For people whose redetermination resulted in a coverage gap in 2026, submitting bills incurred during the gap to healthcare.gov Marketplace coverage that started after the gap may require extra documentation. The 1095-A form issued at year-end reflects your Marketplace coverage start date, which determines which months of care are covered by the new plan.
Medicaid Eligibility After Redetermination: Income Thresholds and the Coverage Decision Tree
Losing Medicaid at redetermination does not necessarily mean you are permanently ineligible. The 2026 Medicaid income thresholds for expansion states remain at 138% of the Federal Poverty Level: $22,025 for a single person, $29,820 for a household of 2, $37,615 for a household of 3, and $45,540 for a family of 4. Alaska and Hawaii thresholds are higher. In the 10 non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming), adult income limits are much lower and based on categorical eligibility rather than a uniform percentage. The coverage decision tree after a 2026 redetermination runs in this order: first, verify whether your income genuinely exceeds the Medicaid limit or whether the termination was a data-matching error. Second, if you genuinely exceed Medicaid limits, check Medicaid income limits to confirm where your income falls relative to the 400% FPL subsidy cliff. Third, if you are between 138% and 400% FPL, apply through healthcare.gov or your state Marketplace using the 90-day SEP. Fourth, if you are above 400% FPL ($63,840 for a single person in 2026), full Marketplace premiums apply with no ACA subsidy due to the 2026 subsidy cliff. Fifth, regardless of adult eligibility, check CHIP separately for any children in your household.
Frequently Asked Questions
How long do I have to enroll in an ACA Marketplace plan after losing Medicaid at redetermination?
You have 90 days from the date your Medicaid coverage ended to enroll in an ACA Marketplace plan. This is a longer Special Enrollment Period than the standard 60-day SEP that applies to most other coverage losses. Log in to healthcare.gov, select 'I lost qualifying health coverage,' choose Medicaid or CHIP as the type of coverage lost, and enter your Medicaid termination date. Your 90-day window closes on day 90 from that termination date, not from when you received the notice. For a termination effective July 1, 2026, your window closes September 28, 2026.
What documents do I need to prove my Medicaid loss for the healthcare.gov SEP?
The primary document required is your official Medicaid termination notice or letter from your state Medicaid agency. Healthcare.gov calls this 'proof of loss of qualifying coverage.' The letter must show the coverage end date and should include the reason for termination. Upload it within 30 days of selecting your Marketplace plan. If you lost your termination letter, contact your state Medicaid agency to request a duplicate notice. Pay stubs or income documentation are not a substitute for the termination notice when applying for the loss-of-Medicaid SEP.
Can I appeal a Medicaid termination from a 2026 redetermination?
Every state must provide a fair hearing process for Medicaid terminations. Submit your appeal request before the deadline in your termination notice, typically 30 to 90 days from the notice date depending on your state. If you file the appeal before your coverage end date, most states must continue your benefits during the appeal. Work requirement terminations can be appealed if you believe you qualify for an exemption (disability, caregiver, student, pregnancy, age over 64). Income-based terminations can be appealed with documentation showing your actual current income is at or below the Medicaid limit.
What changed with Medicaid redeterminations under the OBBBA in 2026?
The One Big Beautiful Bill Act (OBBBA), signed July 4, 2025, made three major changes affecting 2026 redeterminations: (1) Work requirements for expansion adults ages 19 to 64 are now federally authorized; Nebraska implemented them May 1, 2026, with Montana, Iowa, and other states following. (2) Starting December 31, 2026, expansion adults must renew every six months instead of annually. (3) Retroactive Medicaid coverage for expansion adults shrinks from 3 months to 1 to 2 months effective January 1, 2027. Stricter income verification rules through data matching are also generating more administrative terminations in 2026.
Do the 2026 Medicaid work requirements apply to me?
Work requirements apply to expansion adults ages 19 to 64 in states that have implemented them. As of June 2026, Nebraska is the only state with active work requirements (implemented May 1, 2026). Montana and Iowa plan implementation by end of 2026. All states must comply with work requirements by January 1, 2027. Federal exemptions include: people with documented disabilities or serious medical conditions; pregnant women or those 60 days post-partum; primary caregivers of children under 14 or disabled adults; full-time students enrolled at least half-time; people age 65 or older; and recipients of SSI, SSDI, or TANF. Check your state Medicaid agency website for current implementation status.
Will my children lose Medicaid when I lose mine at redetermination?
Not necessarily. Children's Medicaid and CHIP eligibility is evaluated separately from adult eligibility. Even if your income makes you ineligible for adult Medicaid, your children may qualify for Medicaid or CHIP at income levels up to 200% to 300% FPL depending on your state. CHIP enrollment is year-round and there is no 90-day deadline. Apply through healthcare.gov or your state CHIP agency. State CHIP programs include California's Medi-Cal for Kids, Wisconsin's BadgerCare Plus for children, New Jersey's NJ FamilyCare, Connecticut's HUSKY Health for Kids, and Massachusetts's MassHealth Standard.
What are the 2026 Medicaid income limits by state?
For the 40 expansion states plus DC, the standard Medicaid income limit for non-disabled adults is 138% FPL: $22,025 for a single person, $29,820 for 2, $37,615 for 3, and $45,540 for a family of 4 (2026, 48 contiguous states plus DC). Alaska and Hawaii use higher FPL guidelines. The 10 non-expansion states have much lower limits for adults, generally covering only parents at very low income levels. A full 50-state income limit table is available at the Medicaid income limits page on this site, with every state's threshold by household size.
Does the 2026 ACA subsidy cliff affect me if I switch from Medicaid to a Marketplace plan?
Yes, if your income is above 400% FPL ($63,840 for a single person, $132,000 for a family of 4 in 2026). The enhanced premium tax credits from ARPA and the IRA expired January 1, 2026, so people above 400% FPL receive no ACA subsidy. Standard premium tax credits apply for incomes from 100% to 400% FPL: a Silver plan for a single person at 200% FPL ($31,920) typically costs $50 to $150 per month after credits in 2026. For incomes under 250% FPL, Silver plans also include cost-sharing reductions that dramatically lower deductibles and out-of-pocket maximums.
