Medicaid Work Requirements Expected to Challenge 40 States, Risk Coverage Loss

A provision in the tax and spending bill signed into law by President Donald Trump mandates that 40 states plus Washington, D.C., which have expanded Medicaid, begin verifying millions of enrollees’ monthly work status by the end of next year. These recipients must prove they are working, volunteering at least 80 hours a month, or attending school at least half-time, with states required to check this paperwork at least twice a year. Although the law provides $200 million for fiscal year 2026 to help states implement these requirements, experts warn that this funding is insufficient and the deadline challenging to meet, potentially resulting in many enrollees losing coverage. States like North Carolina estimate that hundreds of thousands could lose Medicaid due to administrative burdens, and the necessary technology to streamline verification processes remains complex and resource-intensive. Georgia’s existing program, Pathways to Coverage, highlights practical difficulties, with enrollees facing significant bureaucratic hurdles in proving compliance, demonstrating potential nationwide challenges as new work requirements are enforced. Health advocates express concern that these new bureaucratic hurdles will impose substantial barriers for low-income Americans relying on Medicaid for health coverage.