The Medicaid program is guided by federal government and regulated by states. State governments set up eligibility and benefit standards. Most states require immigrants to be a permanent resident for five years to qualify for this program. Before 2014, parents without minor children are not eligible for Medicaid, and the income standard for parents caring for minors is very low. Affordable Care Act requires states to expand Medicaid programs for adults with income below 138% of the Federal Poverty Line (FPL). But so far, 19 states have not implemented this provision. In these states, the eligibility and benefits still follow their existing state policy.

Income limits for pregnant women and children vary from state to state, from 138% to 300% of the poverty line. Income limits may be adjusted annually by states. When applicants submit an application on the federal or state Marketplace, Marketplace will determine their eligible programs based on family size, household income, immigration status, and residence state. Pregnant women and children programs have different immigration status requirement than adult Medicaid program. Illegal pregnant women are also qualified for Medicaid for pre- and post-delivery. Applications for these government-funded programs should be submitted to local state agencies since those programs are managed by states. Arkansas, Pennsylvania and Iowa pilot with Medicaid funds to subsidize Obamacare plans in Marketplace for some newly qualified low-income families.