Medicaid work requirements for ACA expansion adults
Enacted10/10
⚖ implementation rule in litigation
Federal · H.R.1, One Big Beautiful Bill Act, Pub. L. 119-21 §71119 · Signed Jul 4, 2025
Impact 10/10
Requires most Medicaid enrollees ages 19-64 covered through the ACA expansion group to document at least 80 hours/month of work, education, or community service (an income test can also satisfy it). Exemptions for pregnancy, medical frailty, and caregiving. CBO projects millions will lose coverage. A June 2026 CMS rule requires states to implement by Jan 1, 2027; 25 states are suing over the rule, and a preliminary injunction was denied in July 2026.
HealthcareEducationWorking-age adultsLow-incomeParents / caregiversDisabledImmigrants
Sources
✓ Verified against primary sources 2026-08-15