 [ Symptoms ] my state did not expand medicaid what if your annual income is below 11 500 and you do not qualify for medicaid  can you still use the health insurance exchange [ Disease ] the perverse situations in states that do not expand medicaid is that it is people with the lowest incomes who can not afford insurance without financial help who will be left without options only people with incomes between 11 490 and 46 000 annually are eligible for subsidies below that the law requires people to get coverage through medicaid so in states not expanding the program people earning less that 11 490 would have to pay the full cost of private insurance or go without coverage