How Long Does Continuous Eligibility Last for Kids on Medicaid/CHIP? (2026)

Direct Answer: 12 Months Everywhere, Up to 24+ in a Few States

It depends on your state. Every state must provide children enrolled in Medicaid or CHIP at least 12 months of continuous eligibility in 2026, a mandatory federal floor since January 1, 2024. Oregon extends this to 24 months for children ages 6 to 18. Washington, New Mexico, Hawaii, Minnesota, New York, Pennsylvania, North Carolina, and Colorado offer multi-year continuous eligibility for young children. CMS said in July 2025 it will not approve new multi-year waivers.

The Federal 12-Month Floor Since January 2024

Congress made 12 months of continuous eligibility mandatory nationwide through Section 5112 of the Consolidated Appropriations Act, 2023, effective January 1, 2024. Before that date, continuous eligibility for children was a state option under Medicaid and the Children's Health Insurance Program (CHIP); roughly 33 states adopted it voluntarily, while the rest re-checked family income every six months and could terminate a child's coverage mid-year the moment a paycheck went up. In 2026, every state must lock in coverage for the full 12-month benefit period for children under 19 enrolled in a mandatory or optional Medicaid eligibility group, plus all targeted low-income children enrolled in a separate CHIP program. That protection holds even if the family's income rises, a parent changes jobs, or the household composition shifts during the year.

Federal law allows only three narrow exceptions to the 12-month protection. A state can end a child's coverage early if the child dies, if the child or their representative asks to be disenrolled, or if the state determines eligibility was granted in error at the last determination because of agency mistake, fraud, abuse, or perjury. Outside those three situations, a Medicaid or CHIP agency cannot drop a child mid-year for income changes, a missed paperwork deadline that falls inside the coverage period, or a move between counties within the same state. Renewal still happens once the 12-month period ends, and that is when the state re-checks income against the current federal poverty level (FPL) threshold.

• The child dies during the coverage period.
• The child or their representative requests voluntary disenrollment.
• The state finds eligibility was granted in error because of agency mistake, fraud, abuse, or perjury.

States That Go Beyond 12 Months: Oregon's 24-Month Model and Multi-Year Waivers

Oregon became the first state to move past the 12-month floor. CMS approved Oregon's Bridge 1115 demonstration in 2022, giving children ages 0 to 6 continuous Medicaid or CHIP coverage that runs until their sixth birthday rather than resetting every year, and giving children ages 6 to 18 (plus most adult enrollees) 24 months of continuous eligibility instead of 12. An Oregon family renews every two years instead of every one, cutting the number of paperwork deadlines in half for school-age kids and eliminating them almost entirely for infants and toddlers.

Eight more states built similar multi-year protections for young children using the same Section 1115 waiver authority. Washington, New Mexico, Hawaii, Minnesota, New York, Pennsylvania, and North Carolina all cover children from birth to age 6 without an annual income recheck, and Colorado extended continuous eligibility through age 3. Combined with Oregon, roughly nine states carry CMS approval for some form of continuous eligibility longer than 12 months as of 2026, though the design differs by state: some cover only infants and toddlers, others stretch protection all the way through age 18.

Is Multi-Year Continuous Eligibility Going Away? The 2025 CMS Policy Shift

CMS signaled a reversal on July 17, 2025. The agency told states it does not anticipate approving any new Section 1115 waiver requests for continuous eligibility longer than 12 months, for children or adults, and does not plan to extend approvals that are already on the books once they expire. CMS cited fiscal and program integrity concerns as the reason, even though independent research shows multi-year continuous eligibility reduces coverage gaps and improves child health outcomes by keeping kids connected to a regular doctor.

The earliest existing multi-year waiver was scheduled to expire as soon as December 2025, and some approvals run as late as 2029, so the phase-out will play out state by state rather than all at once. A family in Oregon, Washington, New Mexico, Hawaii, Minnesota, New York, Pennsylvania, North Carolina, or Colorado should check with their state Medicaid or CHIP agency each year in 2026 and beyond, because a state's multi-year protection could revert to the standard 12-month floor once its waiver lapses and is not renewed.

What Counts as Income Before Continuous Eligibility Starts

Continuous eligibility only protects a child after the family already qualifies, so the income test at initial application or renewal still matters. States use Modified Adjusted Gross Income (MAGI), the same MAGI calculation used for ACA marketplace subsidies, to measure household income against the federal poverty level (FPL) for the family's household size. Most states place the Medicaid income floor for children well above the 138% FPL threshold used for the ACA's Medicaid expansion population, and a state's Medicaid expansion status for adults does not change a child's separate, typically higher, income limit.

CHIP then picks up children whose family income is too high for Medicaid but still below the state's CHIP cap, which federal law sets at a minimum of 200% FPL and which many states raise higher. The table above shows the federal 200% FPL floor by household size for 2026; a state without an ACA Medicaid expansion for adults can still run a full-scope CHIP program for kids, so families in non-expansion states such as Texas, Florida, or Wyoming should not assume their children are shut out.

Children's Medicaid and CHIP eligibility differs from the ACA coverage gap affecting low-income adults in the 10 non-expansion states, because kids' income limits are set separately from the adult expansion threshold and exist in all 50 states and DC regardless of a parent's own coverage gap.

How to Apply for Medicaid or CHIP for Your Child in 2026

Families can apply for children's Medicaid or CHIP any day of the year; there is no open enrollment window. Once approved, the continuous eligibility clock, 12 months in most states, longer in Oregon and the eight states with multi-year waivers, starts from the enrollment or renewal date. The fastest path for most families is the single online application at HealthCare.gov or InsureKidsNow.gov, which screens for both Medicaid and CHIP at the same time and forwards the family to the correct state program.

Documents Needed and Common Reasons Coverage Gets Interrupted

Most states ask for the same core documents regardless of whether the child ends up in Medicaid or CHIP: proof of income, the child's birth certificate, proof of state residency, Social Security numbers if available, and proof of current insurance status if any. Missing or incomplete documents remain the single most common reason an application is delayed or denied, so gathering everything before applying speeds up the 30-to-45-day decision window most states target.

Even with continuous eligibility protection, a child's coverage can still end for a handful of reasons. Turning 19 always ends CHIP and most child-specific Medicaid eligibility, regardless of where a family is inside the 12-month or multi-year period. Moving to a new state resets the process, because continuous eligibility does not transfer between states; the family must reapply and the new state's period, 12 months, or longer if that state has a multi-year waiver, starts over. A state's multi-year waiver expiring and not being renewed, per the 2025 CMS guidance, can also shorten future protection back to the 12-month floor at the next renewal.

What is continuous eligibility for children's Medicaid or CHIP?

Continuous eligibility is a guarantee that once a child is enrolled in Medicaid or CHIP, coverage stays in place for the full benefit period, no matter what happens to family income in between. Every state must provide at least 12 months of continuous eligibility for children under 19 as of January 1, 2024, under Section 5112 of the Consolidated Appropriations Act, 2023. A handful of states extend that protection to 24 months or longer for young children in 2026.

Which states offer more than 12 months of continuous eligibility for kids?

As of 2026, roughly nine states have CMS approval for continuous eligibility beyond the 12-month federal floor. Oregon covers children ages 6 to 18 for 24 months and children ages 0 to 6 continuously until their sixth birthday. Washington, New Mexico, Hawaii, Minnesota, New York, Pennsylvania, and North Carolina cover children from birth to age 6, and Colorado covers children through age 3.

Is Oregon's 24-month continuous eligibility ending?

Not immediately, but its future is uncertain. CMS announced on July 17, 2025 that it does not plan to approve new multi-year continuous eligibility waivers or extend existing ones once they expire. Oregon's waiver has not been terminated, but families should check with the Oregon Health Authority each year, because the 24-month benefit could revert to the 12-month federal floor when the waiver comes up for renewal.

What income limit applies before a child qualifies for CHIP in 2026?

The federal CHIP floor is 200% of the federal poverty level (FPL), which is $66,000 a year for a family of four in 2026. Many states set a higher cap, some as high as 400% FPL. Medicaid's separate income limit for children is usually higher than the 138% FPL threshold used for adult Medicaid expansion. Check the household-size table above for the 200% FPL floor at other family sizes.

What documents do I need to apply for Medicaid or CHIP for my child?

You will typically need proof of income such as recent pay stubs or a tax return, your child's birth certificate, proof that you live in the state where you are applying, and Social Security numbers for household members if you have them. Some states also ask about your child's current insurance status. Missing documents are the most common reason applications get delayed or denied.

Can my child lose Medicaid or CHIP coverage during the continuous eligibility period?

Almost never for income reasons. Federal law allows a state to end a child's coverage early only if the child dies, the family requests disenrollment, or the state finds that eligibility was granted in error because of agency mistake, fraud, abuse, or perjury. A pay raise, a new job, or a change in household composition cannot end coverage mid-period.

What happens when the 12-month or 24-month period ends?

Your state sends a renewal notice before the continuous eligibility period ends and re-checks household income against the current year's FPL limits. If income still falls under the state's CHIP or Medicaid cap for children, coverage renews for another full period. Responding to the renewal notice by the deadline is the single biggest factor in avoiding a coverage gap.

Is continuous eligibility different for children than for adults?

Yes. The 12-month continuous eligibility mandate under the Consolidated Appropriations Act, 2023 applies only to children under 19 in Medicaid and CHIP; it is not required for adults. A smaller number of states separately requested continuous eligibility periods for adults through Section 1115 waivers, but CMS's July 2025 guidance signaled it will not approve new adult continuous eligibility waivers either.