The Affordable Care Act's expansion of Medicaid eligibility was meant to close gaps in coverage for low-income adults by setting a national income eligibility level of 138 percent of the federal poverty level (about $27,000 for a family of three). However, in states that do not expand Medicaid, more than 5 million poor uninsured adults will fall into a coverage gap of earning too much to qualify for Medicaid but not enough to qualify for premium tax credits to purchase insurance through an exchange. A new report from the Kaiser Commission on Medicaid and the Uninsured provides estimates of that population.

As of January, the median eligibility for parents in states not expanding will be 47 percent of FPL, or about $9,400 a year for a family of three. Only four states not expanding Medicaid (Alaska, Maine, Tennessee and Wisconsin) cover parents up to the FPL, and eligibility limits in some states are less than 20 percent of FPL (16 percent in Alabama, 19 percent in Texas). Of the states not moving forward with the expansion, only Wisconsin provides Medicaid coverage to adults without dependent children.

A fifth of people in the coverage gap reside in Texas; 16 percent live in Florida; 8 percent in Georgia; 7 percent in North Carolina; and 6 percent in Pennsylvania.

The population in the coverage gap represents 27 percent of the uninsured adult population in states that are not expanding Medicaid. This share ranges across states, from a low of 18 percent in Alaska to a high of 37 percent in Mississippi.

For more information, go to