I Live in a State That Didn't Expand Medicaid, Can I Still Get a Subsidy?

While there are steep fines for knowingly lying on a government application for financial assistance, if someone merely miscalculates their income above the poverty level, and is later found to have made less than the poverty level, they won’t have to pay any money back, according to the Treasury Department.

Under the Affordable Care Act, everyone under 138 percent of the federal poverty level, or about $22,025 for an individual based on the 2026 poverty guidelines used for 2027 coverage, was supposed to qualify for Medicaid. But after the Supreme Court made the Medicaid expansion optional in 2012, some states chose not to expand the program. Texas and Florida are the two biggest states that have not expanded Medicaid.

Medicaid is a much more affordable option for people at or near the poverty level because of its limited out of pocket costs, but experts say qualifying for subsidies to get private insurance would be better than having no coverage.