Nearly one in five Medicaid-eligible adults may miss new 80-hour work rule

A recent study suggests that nearly one-fifth of Medicaid-eligible adults in states that expanded Medicaid may struggle to meet new federal work hour requirements, which will take effect on January 1, 2027. Women, unmarried individuals, white people, and those with limited education face a higher risk of not meeting the 80-hour monthly work quota due to noncompliance.

This could lead to up to 10 million people losing their Medicaid coverage across the United States. The administrative burden of enforcing these work requirements is expected to be a significant factor in disenrollment from Medicaid. The study, led by researchers from Boston University School of Public Health and the University of South Carolina's Arnold School of Public Health, found that millions of Medicaid enrollees may lose their health coverage due to their inability to achieve the required work hours.

Certain groups, including women, unmarried people, and individuals with limited education, were more likely to fall short of the minimum work hours needed. The study highlights the challenges faced by low-wage workers, particularly those in retail, hospitality, and healthcare industries, who often have irregular schedules and struggle with transportation, child care, and health issues.

Single mothers with older children are particularly vulnerable as they must adhere to the work requirements without the option of a recognized disability exemption. The findings challenge the belief that Medicaid recipients can simply "pull themselves up by their bootstraps." The researchers emphasize that supporting people through Medicaid actually helps them maintain stable employment, as better-managed health conditions lead to more predictable work schedules.