Medicaid

As of September 20, 2026, four states enforce Medicaid work requirements: Georgia (since 2023, through its Pathways program), Nebraska (since May 1, 2026), Montana (since July 1, 2026), and Arkansas (since July 1, 2026, in a no-penalty “soft launch”). Iowa starts December 1, 2026. Every other state covered by the rule must implement it by … Read more

Nebraska became the first state in the country to enforce the new federal Medicaid work requirement, on May 1, 2026. The requirement applies to non-exempt adults ages 19–64 in Nebraska’s Medicaid expansion program (Heritage Health Adult). Roughly 90,000 expansion adults are being tracked, and since August 2026 the state has been ending coverage for enrollees … Read more

Georgia has enforced a Medicaid work requirement longer than any other state since July 2023, through its Pathways to Coverage program. Pathways covers adults ages 19–64 with incomes up to 100% of the federal poverty level who complete at least 80 hours per month of qualifying activity. The program’s current extension runs through December 31, … Read more

SNAP and Medicaid now both use an 80-hour monthly work rule but they are separate programs with different penalties, different schedules, and exemptions that moved in opposite directions. SNAP’s updated rules took effect November 2025; Medicaid’s national requirement starts January 1, 2027 (earlier in a few states). If you’re in a household that receives both, … Read more

Federal law exempts ten groups from the Medicaid work requirement, and states must identify exempt people from their own data before asking anyone for paperwork. The exemptions cover pregnancy and postpartum, caregiving for a child age 13 or under or a person with a disability, medical frailty, American Indian and Alaska Native status, former foster … Read more

You can satisfy the Medicaid work requirement five ways in any given month: 80 hours of work; 80 hours of qualifying community service; participation in a work program; enrollment in school at least half-time; or any combination — and separately, monthly income of at least $580 satisfies the requirement with no hour-tracking at all. Seasonal … Read more

If your Medicaid coverage ends over the work requirement, three things are true: you had a 30-day window before it ended, you can appeal the decision, and you can reapply the moment you can document compliance or an exemption. You also likely qualify for a special enrollment period on the ACA marketplace, where subsidies can … Read more