What's new on Medicaid Work Rules
Rule changes, official announcements and new tools, newest first. Each entry links to the pages we changed.
New: Medicaid work requirement guides in Spanish (en español)
The checker, the hours calculator, the exemptions guide, the notices and appeals guide, and the state list are now in Spanish, with Spanish guides for California, Colorado, Georgia, Illinois, Nevada, New Jersey, New Mexico, New York, North Carolina and Arizona. The Spanish checker and calculator give their results in Spanish and use the same rules as the English tools. Each English page with a translation links to it.
New: who has to meet the work requirement, group by group
We added plain-language pages for 13 groups, including parents and caregivers, students, pregnant people, people with disabilities, veterans, American Indians and Alaska Natives, former foster youth, and people leaving jail or prison. Each one gives the exact rule, the proof usually needed, and what to do. While checking the CMS rule, we made two fixes: veterans paid at the 100% rate through individual unemployability (TDIU) are exempt, not only veterans rated 100%, and the former foster youth exemption covers youth from any state who had Medicaid while in foster care. We also added the high-unemployment exception CMS approved for Dawson County, Nebraska, in July 2026.
Who is affected · Veterans · High-unemployment areas · Exemptions guide
Court strikes down the "significantly impairs" test for medically frail
On October 29, 2026, a federal court in Massachusetts v. Oz vacated the CMS rule's extra requirement that a condition must "significantly impair" your ability to meet the work rule. Being in any of the five medically frail categories in the law is now enough. The January 1, 2027 start date did not change, and CMS may appeal. We updated the checker, the exemptions guide and every state page to follow the ruling.
Medicaid Work Rules launches with a checker and 43 state guides
The site launched with a step-by-step checker for the 80-hour community engagement requirement, an hours calculator, a full exemptions guide, and a guide for each state where the rule applies, based on Public Law 119-21 and the CMS interim final rule published June 3, 2026.
Sources
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- Public Law 119-21 (H.R. 1), sec. 71119 (GovInfo)
- Nebraska DHHS: Dawson County approved for temporary exemption from Medicaid work requirements (July 17, 2026)
- Massachusetts v. Oz, No. 1:26-cv-12962-RGS (D. Mass.), memorandum and order (Oct. 29, 2026)