About Medicaid work requirements

Medicaid work requirements are rules that tie Medicaid coverage to completing qualifying activities, such as work, school, or training. You may have also seen them called community engagement requirements. 

In 2025, Congress passed H.R. 1, establishing a new federal requirement that connects Medicaid coverage to work or community engagement. For the first time, certain adults must document that they are working or participating in qualifying activities to keep their health coverage.

Under federal law, states must begin implementing the new work requirements by January 1, 2027. However, states can choose to implement the requirement earlier.

What’s involved?

Some adults with Medicaid must complete qualifying activities each month to keep their Medicaid coverage. For people who must meet the requirements, this generally means completing at least 80 hours per month of qualifying activities.

A “qualifying activity” is an activity that counts toward your monthly hourly requirement. Each state may have different rules about which activities count and how people report them.

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Do the work requirements apply to me?

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The requirements do not apply to everyone with Medicaid. They apply to certain adults who meet specific criteria.

Your age, the type of Medicaid coverage you have, and other circumstances may determine whether the requirements apply to you.

Some people may qualify for an exemption from the requirements based on their circumstances. The rules about who qualifies for an exemption may vary by state.

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What activities count as qualifying activities?

Depending on your state’s rules, qualifying activities may include work, school, community service, or job training. You may also be able to meet the requirements based on your month’s income, which for 2026, is $580 per month. 

Read our guide about which activities may count, how to track your hours, what records to keep, and how to report your activities.

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What are my state’s Medicaid work requirements?

Your state Medicaid office is the best place to find current information about the requirements in your state. Contact your state Medicaid office if you have questions about:

  • The requirements in your state
  • Which activities count
  • How to report your activities
  • Reporting deadlines
  • A notice you received
Find your state Medicaid agency
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If you don’t meet requirements

If the requirements apply to you, and you do not meet them or report your activities as required, you could lose your Medicaid coverage. Your state Medicaid office can tell you what may happen based on your situation and your state’s rules.

Your state Medicaid office should send you information about what you need to do and when you need to do it. States are required to communicate about these requirements by mail or electronically, along with at least one additional communication method. That could include:

  • Phone calls 
  • Text messages 
  • State Medicaid websites 
  • Other electronic communications 
  • Other outreach formats 

Check your state’s Medicaid website to find current information about the requirements in your state.

What to do if you lose Medicaid coverage

If you get a notice about your Medicaid coverage ending, read our guide before you take action. Find out whether you can appeal to keep Medicaid coverage, how to prepare now if you will lose coverage, and what options for health coverage you can explore.

Learn what to do
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