Who it applies to
The requirement generally applies to adults aged 19 to 64 who are covered through the ACA Medicaid expansion. They must show at least 80 hours a month of work, community service, a work program or education (or a combination), or meet an income test, to enroll or keep coverage at renewal.
Who is exempt
The law lists exemptions, including (among others) parents and caregivers of young children or people with disabilities, pregnant and postpartum individuals, people who are medically frail or have certain disabilities, and people in substance use disorder treatment. States handle the details, so check with your state Medicaid agency.
How to protect your coverage
- Make sure your state Medicaid agency has your current address, phone and email.
- Open and respond to every letter from your agency.
- Keep records of work hours, school enrollment or volunteering.
- If you think you are exempt, ask how to claim the exemption.
- If you lose coverage, ask about appeals and check Marketplace options.
General information, not medical, legal or insurance advice. This post reflects the position on the date shown. Check the official sources below for the latest rules.
Last updated: 15 October 2026
