By Kashmira Konduparty
The Trump administration on June 1 released new guidance detailing who will be exempt from upcoming Medicaid work requirements, offering states a framework for implementing one of the most significant changes to the federal health insurance program in years, according to a report by NBC News.
The policy, scheduled to take effect on Jan 1, 2027, requires many able-bodied adults enrolled in Medicaid to complete at least 80 hours of work, education, job training, community service or other qualifying activities each month in order to maintain coverage. The requirement was included in legislation signed by President Donald Trump last year.
Under the guidance issued by the Centers for Medicare & Medicaid Services (CMS), several groups will be exempt from the new rules. Pregnant individuals, people receiving postpartum care, those work disabilities and individuals considered medically frail will not be required to meet work reporting obligations. People who already satisfy work requirements through the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps, will also be exempt.
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CMS said states must verify eligibility and compliance at least every six months, though states may choose to conduct reviews more frequently. Federal officials said the agency plans to rely heavily on electronic data sources, including medical claims information, to determine whether beneficiaries qualify for exemptions and to reduce paperwork burdens.
For the first year of implementation, Medicaid recipients will generally be allowed to self-attest that they have met work requirements. Beginning in 2028, enroll
lees will be required to provide documentation after an initial self-attestation period, according to CMS officials.
CMS Administrator Mehmet Oz said the administration’s goal is to encourage able-bodied adults to move into employer-sponsored health insurance while preserving Medicaid resources for vulnerable populations. The agency also announced $200 million in grants to help states develop systems needed to implement the new requirements.
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The guidance arrives as states prepare for the nationwide rollout of the policy. Medicaid, which is jointly funded by federal and state governments, provides health coverage to millions of low-income Americans. State agencies will be responsible for determining compliance, processing exemptions and conducting outreach to affected beneficiaries before the rules take effect.
The work requirements represent a major shift in Medicaid eligibility rules and are expected to affect adults covered through the Affordable Care Act’s Medicaid expansion programs. Federal officials said additional guidance may be issued as states begin preparing their implementation plans ahead of the 2027 deadline.