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The Medicaid Coverage Gap: State Fact Sheets

Over 1.6 million uninsured adults with low incomes are in the Medicaid coverage gap – unable to qualify for Affordable Care Act (ACA) marketplace assistance because they have incomes below the poverty line, yet ineligible for Medicaid because their state hasn’t enacted the ACA Medicaid expansion. Expanding Medicaid to 138 percent of the federal poverty level ($20,780 for an individual in 2024) would increase health insurance coverage, reduce racial and ethnic health inequities, and improve health care access, health outcomes, and financial security for many adults with low incomes.

These state fact sheets provide basic information and facts about adults in the coverage gap in each state that hasn’t adopted Medicaid expansion.

Wisconsin has not adopted the Medicaid expansion. The state has a Section 1115 demonstration that expands coverage to people up to 100 percent of the federal poverty level. Adopting the Medicaid expansion and extending Medicaid to 138 percent of the poverty level would allow Wisconsin to access an enhanced Medicaid matching rate for that population.

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