Trump signed the big budget bill in July 2025 that created this rule.
It hits adults ages 19 to 64 in the Medicaid expansion group.
They must do 80 hours every month of work volunteering training or school.
The rule starts January 1 2027 in the expansion states and DC.
States can begin earlier and some already did.
Parents of young kids medically frail people and pregnant people get exemptions.
CMS says millions could lose coverage from the new paperwork.
States check at signup and at least every six months.
KFF — August 3 2026
Tracking implementation of the 2025 reconciliation law Medicaid work requirements
https://www.kff.org/medicaid/medicaid-work-requirements-tracker-overview/
KFF — July 30 2025
A closer look at the work requirement provisions in the 2025 federal budget reconciliation law
https://www.kff.org/medicaid/a-closer-look-at-the-work-requirement-provisions-in-the-2025-federal-budget-reconciliation-law/