health
New federal Medicaid rules require 1 month of work. Some states demand more.
April 15, 2026 / 5:00 AM EDT / KFF Health News
TL;DR
- New federal Medicaid rules require beneficiaries to prove at least one month of work, school, or volunteer activity.
- Some states, like Indiana and Idaho, are implementing stricter three-month work requirements.
- Republican lawmakers are driving these stricter requirements, aiming to limit program flexibility.
- The Congressional Budget Office estimates 18.5 million adults will be affected by these new rules in 42 states and D.C.
- Opponents fear the rules will create barriers to essential healthcare for vulnerable individuals, while proponents argue they protect the program's longevity.
- State lawmakers are intervening due to a lack of federal guidance on implementing the new rules.
- Patient advocates and some healthcare providers express concern about the impact on those with chronic conditions or performing unpaid labor.