Who Qualifies for Medicaid in Texas
Texas Medicaid covers children, pregnant women, very low-income parents, and people who are 65 or older or have a disability and meet its limits on income and savings. Most other adults cannot qualify at any income. A single adult under 65 with no children and no disability has no Medicaid pathway in Texas, whether they earn $5,000 a year or nothing.
Children who earn too much for Medicaid can often get the Children’s Health Insurance Program (CHIP), which Texas runs alongside Medicaid with one application. The Texas Health and Human Services Commission (HHSC) decides eligibility for both.
Key facts
Texas Medicaid Income Limits in 2026
For a family of three, children 6 to 18 qualify with household income up to $3,028 a month, and pregnant women up to $4,508. The limits are set as a share of the federal poverty line and change each spring. These are HHSC’s figures in effect since April 1, 2026.
Texas Medicaid and CHIP monthly income limits, 2026
HHSC counts most income the way the IRS does, then subtracts a standard amount equal to 5% of the poverty line, $114 a month for a family of three. With that disregard, KFF puts the Texas parent limit at 15% of poverty, or $4,098 a year for a family of three, the lowest threshold for parents in the country (KFF).
People 65 and older and people with disabilities qualify through separate programs. Those programs have their own limits on income and savings, and many are tied to Supplemental Security Income. HHSC lists them on its Medicaid for the elderly and people with disabilities page.
Did Texas Expand Medicaid?
No. Texas is one of 10 states that never expanded Medicaid under the Affordable Care Act. Expansion covers every adult under 65 with income up to 138% of the poverty line, with the federal government paying 90% of the cost for that group. In Texas, a parent loses Medicaid at about $2,760 a year in a family of three before the disregard, and adults without children have no category at all.
That leaves Texans in what researchers call the coverage gap: too poor for marketplace subsidies, which start at the poverty line, and not eligible for Medicaid. KFF estimates 1.2 million adults are in the gap across the 10 states. 78% have no dependent children, and six in ten live in a family with a worker.
The door has also narrowed. The 2025 federal law ended the extra federal money for any state that expands after January 1, 2026, so expanding would now cost Texas more than it would have. Our national Medicaid explainer compares expansion and non-expansion states.
Why Texas Has the Most Uninsured People
5.2 million Texans had no health insurance in 2024, 16.7% of the population, about 2 times the national rate. Texas holds 9% of the U.S. population but 19% of its uninsured people. Its rate was 4.7 points higher than the next state, Georgia.
| Category | Value |
|---|---|
| Texas | 16.7% |
| Georgia | 12% |
| Oklahoma | 11.5% |
| Nevada | 11.4% |
| Alaska | 11% |
| Florida | 10.9% |
| Arizona | 10.3% |
| Wyoming | 10.3% |
Source: Census Bureau, American Community Survey 2024, Table HI05_ACS. Civilian noninstitutionalized population.
The gap is widest for working-age adults, the group the expansion would have covered.
- 21.6%
- Texans 19 to 64 without insurance (U.S. 11.3%)
- 13.6%
- Texas children under 19 without insurance (U.S. 6%)
- 1.1 million
- Uninsured Texas children, the most of any state
The limits for children in the table above reach well above the poverty line, so an uninsured child may qualify even when a parent does not.
Texas Medicaid Enrollment Since 2023
Texas Medicaid and CHIP enrollment dropped by about 2.0 million people, from 6.0 million in May 2023 to 4.0 million in May 2026. During the pandemic, federal law kept people enrolled. When that ended in spring 2023, states had to recheck everyone’s eligibility.
| Category | Value |
|---|---|
| March 2019 | 4278690 |
| March 2020 | 4206104 |
| March 2021 | 4920949 |
| March 2022 | 5364205 |
| May 2023 (peak) | 5976306 |
| March 2024 | 4360449 |
| March 2025 | 4204178 |
| May 2026 | 3971026 |
Source: CMS, State Medicaid and CHIP enrollment data, Texas, final monthly reports. March of each year, plus the May 2023 peak and the latest final month.
In May 2026, 76% of enrollees were children: 3,004,749 of 3,971,026. CHIP covered 330,567.
New mothers keep coverage longer now. Texas extended postpartum Medicaid and CHIP from 2 months to 12 months after a pregnancy ends, starting March 1, 2024. The governor’s office expected about 137,000 women to benefit in fiscal 2025 (Office of the Governor).
| Period | Value |
|---|---|
| Before March 2024 | 2 months |
| Since March 1, 2024 | 12 months |
| Change | +10 months |
How the 2025 Federal Law Affects Texas Medicaid
The biggest parts of the 2025 law, work requirements and six-month renewals, apply to expansion adults, a group Texas does not have. Other parts reach Texas directly. Here is where each stands.
2025 federal Medicaid changes and Texas
As of September 28, 2026
- Work requirements (Section 71119) Law, expansion adults only
Start by January 1, 2027 for adults covered through the ACA expansion and certain waiver enrollees. Texas has no expansion group. (source)
- Renewals every six months (Section 71107) Law, expansion adults only
Applies to expansion adults for renewals on or after December 31, 2026. (source)
- Immigrant eligibility (Section 71109) Law, all states
From October 1, 2026, Medicaid and CHIP are limited to green card holders, certain Cuban and Haitian entrants, and a few other groups. Refugees and asylees without a green card lose eligibility. (source)
- Retroactive coverage (Section 71112) Law, all states
From January 1, 2027, Medicaid can pay bills from only 2 months before the application for enrollees outside the expansion group. (source)
- Provider taxes (Section 71115) Law, freeze
Since July 2025, no state may create a new provider tax or raise an existing rate. Non-expansion states such as Texas face the freeze but not the later cuts. (source)
- State-directed payments to hospitals (Section 71116) Law, phase-down from 2028
New payments are capped at 110% of Medicare rates in non-expansion states. Existing payments above the cap shrink starting January 1, 2028. (source)
Source: KFF summaries of the 2025 federal budget reconciliation law, Public Law 119-21
States use provider taxes to raise their share of Medicaid costs, and state-directed payments to pay hospitals more than base rates. The freeze and the 2028 phase-down limit both tools. The national picture, including the work rule’s projected losses, is on our Medicaid explainer.
What to Do, by Situation
Open the situation closest to yours. This is general information, not legal advice. HHSC makes every eligibility decision.
Texas Medicaid and CHIP, by situation
Open the one closest to yours.
I am pregnant and have no insurance
- Apply now at YourTexasBenefits.com. For a family of three, counting the baby, the limit is $4,508 a month.
- If your income is higher, you may still qualify for CHIP Perinatal, which covers prenatal visits, delivery and postpartum care.
- Once you are enrolled, coverage lasts 12 months after the pregnancy ends.
HHSC income limits, 2026; Texas extended postpartum coverage under HB 12 in 2024.
My child lost Medicaid or CHIP
- Read the notice for the reason HHSC gives.
- Reapply at YourTexasBenefits.com with current pay stubs. Children qualify at much higher incomes than parents.
- If you think HHSC made a mistake, ask for a fair hearing by the deadline in the notice.
Texas enrollment fell by about 2.0 million from May 2023 to May 2026 as the state rechecked every case.
I am an adult with no children and no disability
- Texas Medicaid does not cover you at any income.
- If you earn at least the poverty line, check HealthCare.gov for a subsidized marketplace plan.
- If you earn less, look for a community health center or county hospital program near you. Many charge by income.
Texas did not expand Medicaid, so adults without children have no Medicaid category.
I am 65 or older or have a disability
- Apply for Medicare first if you are 65 or have received Social Security disability for two years.
- Ask HHSC about Medicaid for the elderly and people with disabilities. It can pay Medicare premiums and long-term care.
- Have bank statements ready. These programs count savings as well as income.
HHSC runs separate programs for seniors and people with disabilities, with their own income and resource limits.
I am a refugee or asylee without a green card
- Expect a notice. From October 1, 2026, federal law ends Medicaid and CHIP eligibility for many lawfully present immigrants without a green card.
- Talk with a legal aid group or your resettlement agency about your status and other coverage.
- Children born in the U.S. are citizens and keep their own eligibility.
Section 71109 of the 2025 federal law narrows who counts as a qualified immigrant for Medicaid and CHIP.
How to Apply for Medicaid in Texas
Apply online at YourTexasBenefits.com or in the Your Texas Benefits app. You can also apply by phone, by mail, or in person at an HHSC benefit office or a community partner. One application covers several programs, including Medicaid and CHIP.
- Gather proof of income for everyone in the household, such as pay stubs, plus identity and citizenship or immigration documents.
- Answer every question. HHSC says a complete application can move faster.
- Watch your mail and the app. HHSC contacts you if it needs more, and missing a deadline can close the case.
- Renew on time. Update your address with HHSC so renewal notices reach you.
Common Questions About Texas Medicaid
Who qualifies for Medicaid in Texas?
Mostly children, pregnant women, very low-income parents, and people who are 65 or older or have a disability and meet limits on income and savings. For a family of three, children 6 to 18 qualify with household income up to $3,028 a month and pregnant women up to $4,508. A parent in that family qualifies only up to about $230 a month. Most adults without children cannot qualify at any income unless they have a disability.
What is the income limit for Medicaid in Texas?
It depends on who you are. For a family of three in 2026, HHSC lists $4,508 a month for pregnant women and babies, $3,279 for children 1 to 5, $3,028 for children 6 to 18, and $4,577 for CHIP. The limit for parents is $230 a month. HHSC also subtracts a standard $114 before comparing.
Did Texas expand Medicaid?
No. Texas is one of 10 states that never expanded Medicaid under the Affordable Care Act, which would cover adults up to 138% of the poverty line with the federal government paying 90% of the cost. The 2025 federal law ended the extra federal money for states that expand after January 1, 2026.
How do I apply for Medicaid in Texas?
Apply online at YourTexasBenefits.com or in the Your Texas Benefits app, by phone, by mail, or in person at an HHSC benefit office or community partner. One application covers Medicaid, CHIP and other benefits. Answer every question you can, because missing information slows the decision.
How long does pregnancy Medicaid last in Texas?
Twelve months after the pregnancy ends. Texas extended postpartum Medicaid and CHIP coverage from 2 months to 12 months starting March 1, 2024, under House Bill 12.
Do Medicaid work requirements apply in Texas?
Mostly no. The 2025 federal work requirement applies to adults covered through the Affordable Care Act expansion, starting by January 1, 2027. Texas never expanded, so it has no expansion adults. Other parts of the law do reach Texas, including new limits on which immigrants qualify (October 1, 2026) and shorter retroactive coverage (January 1, 2027).
What You Can Do
- Check your family’s eligibility against the income table, and apply for any child who may qualify. Children qualify at far higher incomes than adults.
- Keep your contact information current with HHSC so renewal notices reach you.
- Share this page with anyone who is pregnant or recently gave birth, since coverage now lasts 12 months.
- Ask your state legislators where they stand on Medicaid expansion and how Texas will cover the federal cuts to hospital payments. The Legislature next meets in January 2027. Find your members with Who Represents Me and use our letter-writing guide.