Who has to meet the work requirement?
Adults ages 19 to 64 who are not pregnant, are not entitled to or enrolled in Medicare, and get Medicaid through their state's adult expansion group or certain state waiver programs. CMS says 43 states and the District of Columbia cover these adults. States can start earlier than January 1, 2027, and Nebraska already has.
Our state pages show whether each state we serve expanded Medicaid.
How can I meet the requirement?
- Work at least 80 hours a month
- Do at least 80 hours a month of community service or a work program
- Go to school at least half time
- Combine these activities to reach 80 hours
- Have monthly income of at least 80 times the federal minimum wage, which is $580 a month in 2026
If you apply, you must show you met the requirement for at least one month right before the month you apply. If you are already enrolled, you must show it for one or more months between renewals. Your state decides how many months in both cases.
Who is exempt?
- People who are pregnant or getting postpartum coverage
- Parents, guardians, caretaker relatives and family caregivers of a child 13 or younger or of a person with a disability
- People who are disabled, medically frail or have medical needs that make it very hard to comply
- Veterans with a total disability rating
- American Indians and Alaska Natives
- Former foster care youth
- People in a drug or alcohol treatment program
- People who meet the work rules for SNAP or TANF
- People who are incarcerated
States can also grant short-term hardship exceptions, for example during a hospital or nursing home stay, in a county with high unemployment or a declared disaster, or when you must travel for serious medical care.
What happens if I don't meet it?
States check when you apply and at renewal, and your state can choose to check more often. If your state cannot confirm that you meet the requirement or are exempt, it must send you a notice and give you 30 days to show that you do. If you do not, your application can be denied or your coverage can end. You can apply again at any time.
Losing Medicaid this way also affects marketplace savings. People denied or removed from Medicaid for not meeting the work requirement cannot get the premium tax credit, so a marketplace plan would cost full price.
How do I keep my coverage?
- Keep your address, phone number and email current with your state Medicaid agency, and open every letter it sends.
- Report your work hours, school enrollment or exemption when your state asks.
- If you think you are exempt, tell your state and send proof.
- Answer any notice about the requirement within 30 days.
If your income rises above your state's Medicaid limit, you may qualify for a marketplace plan with a premium tax credit instead. A licensed agent can check your options at no cost.
See our Individual & Family plans
Major medical coverage for you and your household, with subsidies applied where you qualify.
Talk to a licensed agent
We compare plans, explain the tradeoffs and help you enroll. It costs you nothing.