New Medicaid Work Rules Will Require 80 Hours a Month, Sick Americans Must Prove They Qualify for Exemptions

WASHINGTON, DC - MAY 13: Administrator for the Centers for Medicare & Medicaid Services Dr. Mehmet Oz speaks alongside Deputy CMS Administrator Kim Brandt (R) during a press conference on the Trump administration's anti-fraud initiatives at the Eisenhower Executive Office Building on May 13, 2026 in Washington, DC. Vance announced plans for the government to cut federal funding for Medicaid expenses in states who fail to comply with anti-fraud safeguards. (Credit: Photo by Chip Somodevilla/Getty Images)

The Trump administration has released new guidance detailing how states will implement Medicaid work requirements, a major policy change that will require many adult beneficiaries to work, volunteer, attend school or participate in job training for at least 80 hours per month to maintain health coverage.

The guidance, issued by the Centers for Medicare & Medicaid Services (CMS), provides the first detailed roadmap for a requirement approved as part of last year's tax and spending legislation. The rules are scheduled to take effect on Jan. 1, 2027.