Medicaid Work Requirement Checker
Answer a few questions to see if the new 80-hour Medicaid rule applies to you, whether you are likely exempt, and what your state will ask for.
Check your situation
Step 1 of 3
The rule in plain words
A new federal law, H.R. 1 (Public Law 119-21), adds a "community engagement" rule to Medicaid. If you are 19 to 64 and get Medicaid through the adult expansion group, you will need to show that in at least one month you did one of these:
- Worked 80 hours, including gig work, self-employment, or unpaid work like an internship
- Did 80 hours of community service with a nonprofit or public agency
- Spent 80 hours in a work program, such as job training
- Went to school at least half-time
- Did a mix of the above that adds up to 80 hours
- Had monthly income of at least $580 (80 hours × the $7.25 federal minimum wage)
Many people are exempt, including parents and caregivers of children 13 or younger, people who are pregnant or postpartum, people with serious health conditions, and American Indians and Alaska Natives. Your state must check its own records first before asking you for anything.
Court ruling, October 29, 2026: a federal court struck down the CMS rule's extra "significantly impairs" test for the medically frail exemption. If you are blind or disabled, or have a substance use disorder, a disabling mental disorder, a disability that limits daily activities, or a serious or complex condition, you count as medically frail. CMS may appeal. What the ruling means.
When it starts
States must start by January 1, 2027. Current members are usually checked at their first renewal on or after that date. A few states started earlier:
- Arkansas: Soft start July 1, 2026; enforced January 1, 2027
- Iowa: December 1, 2026 for new applicants
- Montana: Started July 1, 2026
- Nebraska: Started May 1, 2026
The rule only matters in the 40 states plus DC that expanded Medicaid, and in Georgia (Pathways) and Wisconsin (BadgerCare Plus childless adults). See the state-by-state table.
What happens if you fall short
You will not lose coverage without warning. If your state can't confirm you meet the rule, it must send a notice and give you 30 days to show you comply or are exempt. Your coverage continues during those 30 days, and you have the right to a fair hearing. Read what happens if you don't meet the requirement.
Help others check. Caseworkers and navigators can share a filled-in result: the checker saves your answers in the page address, so you can copy the link after you see a result.
Frequently asked questions
Who has to meet the Medicaid work requirement?
Adults ages 19 to 64 who get Medicaid through the ACA expansion group, plus Georgia Pathways members and Wisconsin BadgerCare Plus childless adults. It does not apply if you are pregnant, have Medicare, or get Medicaid another way, such as through a disability or SSI. Many people in the group are also exempt.
When does the Medicaid work requirement start?
The federal deadline is January 1, 2027. Nebraska started May 1, 2026, Montana July 1, 2026, Arkansas began a soft start on July 1, 2026, and Iowa starts for new applicants December 1, 2026. Current members are usually checked at their first renewal after the start date. A state can ask CMS for a temporary exemption, but it can last no later than December 31, 2028.
Can I combine work, volunteering, and school to reach 80 hours?
Yes. Hours of work, community service, a work program, and less-than-half-time school all add together. If you go to school at least half-time, that counts by itself. Use the hours calculator to add yours up.
Does income count instead of hours?
Yes. If your monthly income is at least $580, you meet the rule for that month no matter how many hours you worked. Medicaid uses its usual income rules, which count household income. Seasonal workers can use their average income over the last 6 months.
I'm a parent. Do I have to meet the requirement?
Not if you are the parent, guardian, or caretaker relative of a child 13 or younger. You are also excluded if you care for a person with a disability. Once your youngest child turns 14, the rule can apply to you unless another exemption fits.
Do I have to meet the requirement every month?
Federal law requires at least one month, but each state chooses how many. Most states check one month since your last renewal. Some ask for more: Idaho, Indiana, Kentucky, Montana, and North Carolina ask for 3 months, and Iowa asks for 2. See look-back periods.
Will I lose Medicaid right away if I miss the hours?
No. Your state must first check its own data, then send a notice and give you 30 days to respond. Coverage continues during that time. If coverage ends, you get written notice and the right to a fair hearing, and you can reapply at any time.
Did a court change the medically frail exemption?
Yes. On October 29, 2026, a federal court in Massachusetts v. Oz struck down the CMS rule's extra requirement that a condition "significantly impair" your ability to meet the work rule. Anyone in one of the five medically frail categories in the law now qualifies. The January 1, 2027 start date did not change, and CMS may appeal. This checker follows the ruling. Like all results here, it is an estimate, not a decision.
Sources
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- CMS fact sheet: community engagement interim final rule (June 1, 2026)
- Massachusetts v. Oz, No. 1:26-cv-12962-RGS (D. Mass.), memorandum and order (Oct. 29, 2026)
- HFMA: court rules on medical frailty in Medicaid work requirement (Oct. 29, 2026)
- KFF: Status of state Medicaid expansion decisions
- U.S. Department of Labor: federal minimum wage