State Policy Documentation Project




Table 7: Treatment of Two-Parent Families Under Medicaid

Table 7 shows whether or not a state has decided to cover two-parent families to the same extent that it covers single-parent families under Medicaid by eliminating the so-called "100-hour" rule. The 100-hour rule, which is a remnant of the old AFDC system, restricts Medicaid coverage to two-parent families in which the principal wage earner works fewer than 100 hours a month. As a result of a regulation issued by the Department of Health and Human Services on August 7, 1998, all states now have the option to effectively drop the 100-hour rule and to provide Medicaid to two-parent families on the same terms that it is available to single-parent families.(21) Even prior to the regulation, a majority of states had statewide waivers that gave them the option to dispense with the 100-hour rule requirement when determining a family's eligibility for Medicaid.

Unless otherwise noted, the information in Table 7 is based on a state's Medicaid rules for two-parent families under its family coverage category. States marked with an "*" have not yet established a family coverage category, but do have a medically needy category and the information in this table is based on their medically needy eligibility rules. States marked with "**" have not yet established a family coverage category, but have expanded coverage to low-income working parents under an 1115 waiver.


Table 7
Treatment of Two-Parent Families Under Medicaid
  Cover two-parent families to the same extent as single-parent families?
Totals 35 Yes
15 No
1 Varies
Alabama Yes
Alaska Yes
Arizona Yes
Arkansas No
California(22) New applicants -- No; Recipients - Yes
Colorado Yes
Connecticut Yes
Delaware Yes
District of Columbia Yes
Florida No
Georgia Yes
Hawaii ** Yes
Idaho Yes
Illinois Yes
Indiana Yes
Iowa Yes
Kansas Yes
Kentucky No
Louisiana No
Maine No
Maryland Yes
Massachusetts ** Yes
Michigan Yes
Minnesota Yes
Mississippi Yes
Missouri Yes
Montana Yes
Nebraska * No
Nevada Yes
New Hampshire No
New Jersey Yes
New Mexico Yes
New York Yes
North Carolina Yes
North Dakota No
Ohio Yes
Oklahoma No
Oregon Yes
Pennsylvania No
Rhode Island Yes
South Carolina


South Dakota Yes
Tennessee No
Texas* Yes
Utah* No
Vermont Yes
Virginia Yes
Washington Yes
West Virginia No
Wisconsin No
Wyoming No


21. Note that two-parent families subject to the 100-hour rule requirement used to also be required to meet a "work history requirement" that restricted coverage to those two-parent families in which the principal wage earner had been employed for at least three out of the previous six months. When Medicaid eligibility for families with children was delinked from cash assistance, the work history requirement was eliminated.
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22. As of March 1, 2000, California also will waive the 100-hour rule for any applicant family with net earnings below 100 percent of the federal poverty level.
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This page last updated September 02, 2023

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