Am I exempt from the Medicaid work requirement?
Nine exception categories, then the 80-hour test. Most people who lose coverage under work requirements were entitled to an exception and did not claim it.
First, does this apply to you?
Do any of these describe you?
Tick everything that applies. Any one of these is an exception — you do not need to meet the hours test at all.
If none of those apply, your monthly activity
You need 80 hours a month, or $580 in earnings, or half-time study. Any one is enough.
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What is changing, and when
Every state operating Medicaid expansion must apply a community engagement requirement to adults aged 19 to 64 in the adult group by 1 January 2027. Nebraska started on 1 May 2026 and Montana on 1 July 2026. The Congressional Budget Office projects 5.3 million more uninsured people as a result; the Urban Institute puts the figure as high as 7 million by 2028.
The requirement itself is not complicated — 80 hours a month, or $580 in earnings, or half-time study. What causes coverage loss is paperwork: people who qualify for one of the nine exceptions but never claim it, and people who meet the requirement but cannot evidence it when asked. For 2027 most states may accept self-attestation for exceptions; from 2028 the rule expects documentation for many categories.
Common questions
When does the Medicaid work requirement start?
States must implement the community engagement requirement by 1 January 2027, and may start earlier. Nebraska began on 1 May 2026 and Montana on 1 July 2026.
How many hours a month do I need?
Eighty hours a month of work, community service or an approved work programme, which can be combined to reach the total. Earning at least $580 a month meets the requirement instead, as does enrolling at least half-time in an educational programme.
Who is exempt from the Medicaid work requirement?
Nine categories: pregnant and postpartum individuals; people who are medically frail or have special medical needs that impair their ability to comply; parents, guardians, caretaker relatives and family caregivers of a child under 14 or of a person with a disability; American Indians and Alaska Natives; former foster care youth; veterans with a total disability rating; people already meeting TANF or SNAP work rules; people in drug or alcohol treatment; and inmates of public institutions.
Does the requirement apply to everyone on Medicaid?
No. It applies to non-pregnant adults aged 19 to 64 who are covered through the Medicaid adult expansion group and are not enrolled in Medicare. Coverage through disability, pregnancy or long-term care routes is not affected.
What happens if I do not comply?
Your state must give you 30 days to demonstrate compliance before disenrolling you. States may also grant short-term hardship exceptions, including for hospitalisation, declared disasters, extended travel for medical care, and living in a county with unemployment at or above 8 percent or 1.5 times the national rate.
Source: Centers for Medicare & Medicaid Services, “Medicaid Program; Community Engagement Requirement for Certain Individuals”, interim final rule with comment period (CMS-2454-IFC), published in the Federal Register on 3 June 2026. Last verified 29 July 2026. This tool is an estimate, not a determination — your state Medicaid agency decides exceptions and compliance, and states differ in how they verify. See also our guide to applying for Medicaid.