Millions will lose Medicaid once new work rules kick in. These groups will be hit the hardest.
More than 10 million Americans could lose Medicaid health insurance under new work rules that begin in January — putting additional burden on people who have already retired and left the workforce, those in rural areas, and even those who are working but can’t get enough hours to meet the minimum to qualify.
Under H.R. 1 — also known as the One Big Beautiful Bill Act — which was signed into law last year, low-income Americans ages 19 to 64 must meet mandatory federal work requirements in order to obtain and keep Medicaid coverage through the Affordable Care Act expansion. That means that these adults must work or participate in community service for at least 80 hours a month or be enrolled in an educational program at least half of the time. There are exemptions for being a parent to young children, serving as a caregiver or being medically frail.
Prior to H.R. 1, there was no federal work requirement, and states wishing to test work requirements had to submit a waiver request to the Centers for Medicare & Medicaid Services.
The changes will cut about $1 trillion from federal Medicaid spending over 10 years. The cuts are part of the Trump administration’s efforts to offset the extension of tax cuts, and to curtail spending and eliminate fraud.