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New federal Medicaid rules require 1 month of work. Some states demand more.

April 15, 2026 / 5:00 AM EDT / KFF Health News

New federal Medicaid rules require 1 month of work. Some states demand more.

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.