Commonwealth Fund September 30, 2025
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The first nationwide work requirements for Medicaid are scheduled to start in 2027, mandating that enrollees work, volunteer, or engage in educational activities for at least 80 hours a month
National Medicaid work requirements will impact an estimated 18.5 million adults, who will have to regularly demonstrate compliance or prove that they qualify for an exemption
This explainer was originally published on April 2, 2024, and was updated on January 14, 2025, and again on September 30, 2025.
For most of its history, Medicaid, the joint state and federal health insurance program for people with low income, has not tied eligibility to employment. This changed during the first Trump administration, which encouraged state Medicaid agencies to test work requirements.
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