Medicaid Work Requirements by State
The 80-hour rule applies in the 40 states and DC that expanded Medicaid, plus Georgia Pathways and Wisconsin's BadgerCare Plus childless adults. Pick your state for dates, contacts, and how to report.
- Alaska
- Arizona
- Arkansas Early
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Georgia Waiver
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa Early
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Missouri
- Montana Early
- Nebraska Early
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Dakota
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin Waiver
All states at a glance
| State | Status | Start | Medicaid program | Details |
|---|---|---|---|---|
| Alabama | Does not apply | — | Alabama Medicaid | Agency site |
| Alaska | Applies | Jan 1, 2027 | Alaska Medicaid | Alaska guide |
| Arizona | Applies | Jan 1, 2027 | AHCCCS (Arizona Health Care Cost Containment System) | Arizona guide |
| Arkansas | Started early | Jul 1, 2026 | Arkansas Medicaid | Arkansas guide |
| California | Applies | Jan 1, 2027 | Medi-Cal | California guide |
| Colorado | Applies | Jan 1, 2027 | Health First Colorado | Colorado guide |
| Connecticut | Applies | Jan 1, 2027 | HUSKY Health | Connecticut guide |
| Delaware | Applies | Jan 1, 2027 | Delaware Medicaid | Delaware guide |
| District of Columbia | Applies | Jan 1, 2027 | DC Medicaid | District of Columbia guide |
| Florida | Does not apply | — | Florida Medicaid | Agency site |
| Georgia | Waiver group only | Jan 1, 2027 | Georgia Medicaid | Georgia guide |
| Hawaii | Applies | Jan 1, 2027 | Med-QUEST (Hawaii Medicaid) | Hawaii guide |
| Idaho | Applies | Jan 1, 2027 | Idaho Medicaid | Idaho guide |
| Illinois | Applies | Jan 1, 2027 | Illinois Medicaid | Illinois guide |
| Indiana | Applies | Jan 1, 2027 | Indiana Medicaid | Indiana guide |
| Iowa | Started early | Dec 1, 2026 | Iowa Medicaid | Iowa guide |
| Kansas | Does not apply | — | KanCare | Agency site |
| Kentucky | Applies | Jan 1, 2027 | Kentucky Medicaid | Kentucky guide |
| Louisiana | Applies | Jan 1, 2027 | Louisiana Medicaid (Healthy Louisiana) | Louisiana guide |
| Maine | Applies | Jan 1, 2027 | MaineCare | Maine guide |
| Maryland | Applies | Jan 1, 2027 | Maryland Medicaid (HealthChoice) | Maryland guide |
| Massachusetts | Applies | Jan 1, 2027 | MassHealth | Massachusetts guide |
| Michigan | Applies | Jan 1, 2027 | Michigan Medicaid | Michigan guide |
| Minnesota | Applies | Jan 1, 2027 | Medical Assistance (Minnesota Medicaid) | Minnesota guide |
| Mississippi | Does not apply | — | Mississippi Medicaid | Agency site |
| Missouri | Applies | Jan 1, 2027 | MO HealthNet | Missouri guide |
| Montana | Started early | Jul 1, 2026 | Montana Medicaid | Montana guide |
| Nebraska | Started early | May 1, 2026 | Nebraska Medicaid (Heritage Health) | Nebraska guide |
| Nevada | Applies | Jan 1, 2027 | Nevada Medicaid | Nevada guide |
| New Hampshire | Applies | Jan 1, 2027 | New Hampshire Medicaid | New Hampshire guide |
| New Jersey | Applies | Jan 1, 2027 | NJ FamilyCare | New Jersey guide |
| New Mexico | Applies | Jan 1, 2027 | New Mexico Medicaid (Turquoise Care) | New Mexico guide |
| New York | Applies | Jan 1, 2027 | New York State Medicaid | New York guide |
| North Carolina | Applies | Jan 1, 2027 | NC Medicaid | North Carolina guide |
| North Dakota | Applies | Jan 1, 2027 | North Dakota Medicaid | North Dakota guide |
| Ohio | Applies | Jan 1, 2027 | Ohio Medicaid | Ohio guide |
| Oklahoma | Applies | Jan 1, 2027 | SoonerCare | Oklahoma guide |
| Oregon | Applies | Jan 1, 2027 | Oregon Health Plan (OHP) | Oregon guide |
| Pennsylvania | Applies | Jan 1, 2027 | Medical Assistance (Pennsylvania Medicaid) | Pennsylvania guide |
| Rhode Island | Applies | Jan 1, 2027 | Rhode Island Medicaid | Rhode Island guide |
| South Carolina | Does not apply | — | Healthy Connections Medicaid | Agency site |
| South Dakota | Applies | Jan 1, 2027 | South Dakota Medicaid | South Dakota guide |
| Tennessee | Does not apply | — | TennCare | Agency site |
| Texas | Does not apply | — | Texas Medicaid | Agency site |
| Utah | Applies | Jan 1, 2027 | Utah Medicaid | Utah guide |
| Vermont | Applies | Jan 1, 2027 | Vermont Medicaid | Vermont guide |
| Virginia | Applies | Jan 1, 2027 | Cardinal Care (Virginia Medicaid) | Virginia guide |
| Washington | Applies | Jan 1, 2027 | Apple Health (Washington Medicaid) | Washington guide |
| West Virginia | Applies | Jan 1, 2027 | West Virginia Medicaid | West Virginia guide |
| Wisconsin | Waiver group only | Jan 1, 2027 | BadgerCare Plus (Wisconsin Medicaid) | Wisconsin guide |
| Wyoming | Does not apply | — | Wyoming Medicaid | Agency site |
"Start" is the date the rule begins in the state. Current members are usually checked at their first renewal on or after it, so many people will first see it in spring 2027.
States that started early
- 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.
States where the rule does not apply
Alabama, Florida, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wyoming have not expanded Medicaid. In these states, the federal work requirement does not apply to regular Medicaid. If one of them expands later, the rule would apply to the new adult group.
Georgia and Wisconsin
Neither state adopted the full ACA expansion, but the law also covers adults in waiver programs that give similar coverage. In Georgia, that means Pathways to Coverage, which switches from its own work rule to the federal one on January 1, 2027. In Wisconsin, it means BadgerCare Plus adults without dependent children.
Can a state delay?
A state can ask CMS for a "good faith effort" exemption if it is working to comply but cannot be ready. CMS approves these for up to 6 months at a time, and no exemption can last past December 31, 2028. As of October 30, 2026, Alaska had said it asked for more time, and North Carolina told CMS it was unlikely to fully meet the new rule's requirements by January 1, 2027. We did not find any approved exemptions.
Frequently asked questions
Which states have Medicaid work requirements?
All 40 states plus DC that expanded Medicaid must apply the rule to expansion adults ages 19 to 64. It also applies to Georgia Pathways members and Wisconsin BadgerCare Plus childless adults.
Which state started Medicaid work requirements first?
Nebraska started May 1, 2026. Montana followed on July 1, 2026. Arkansas began a soft start with no penalties on July 1, 2026, and Iowa starts for new applicants December 1, 2026.
Do non-expansion states like Texas or Florida have the requirement?
No. The federal rule applies only to the expansion group and similar waiver groups. Alabama, Florida, Kansas, Mississippi, South Carolina, Tennessee, Texas, and Wyoming have no expansion group, so it does not apply to their Medicaid programs.
Can my state make the rules stricter?
States choose some details within federal limits, such as how many months to check (1 to 3 at application) and whether to verify more often than at renewal. Idaho, Indiana, Kentucky, Montana, and North Carolina check 3 months, and New Hampshire's state law requires quarterly checks and documents.
Does the rule apply in U.S. territories?
No. The law and CMS rule apply to the 50 states and the District of Columbia only.