Medicaid work requirements

Federal law requires most Medicaid expansion enrollees aged 19 to 64 to complete 80 hours a month of work or other qualifying activities, starting no later than January 1, 2027. Some states may start earlier, and many people are exempt.

Activities that generally count

• Paid work
• Community service
• Approved work programs
• Being enrolled in school at least half-time
• A combination of these adding up to 80 hours

Who may be exempt

• Pregnant and postpartum people
• People who are medically frail or have a serious condition
• Parents and caretakers of young children or people with disabilities
• Certain veterans
• American Indians and Alaska Natives
• Others covered by your state's rules

Who isn't affected

The rule doesn't apply to children, people 65 and older, or people who have Medicare. It's aimed at the expansion group, and states that haven't expanded aren't covered in the same way. Georgia's Pathways program has its own rules.

How to get ready

1. Update your contact details with your agency.
2. Keep pay stubs, school records and volunteer logs.
3. Ask your doctor to document any health condition.
4. Watch for letters explaining your state's process.
5. Ask for help right away if you get a notice.

You can appeal a decision. Find your agency in our state directory.