Unfortunately he can be holding himself back permanently. He should look into options like401k, FSA etc
@aygart mentioned 401K and FSA.
Medicaid eligibility (the "big ticket" program for most) is based on AGI. FSA, HSA, and Traditional IRA contributions all lower AGI.
I'm currently in this situation.
The problem is that Medicaid looks at your monthly paystub, not your previous year tax return. Therefore, contributing to an IRA, charity, childcare, etc. isn't very helpful for lowering ones AGI for eligibility purposes.