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The Guardian - US
The Guardian - US
World
Tobi Thomas Health and inequalities correspondent

Some conservative states aren’t using Medicaid hardship exemption – for political reasons

people hold signs at a protest
Protesters gather for a group photo outside the office of U.S. Sen. Joni Ernst (R-IA) as part of a mock funeral to protest against proposed Medicaid cuts on June 23, 2025 in Davenport, Iowa. Photograph: Matthew Holst/Getty Images for MoveOn

Some conservative states that have rejected hardship exemptions for the new Medicaid requirements may be choosing not to due to political reasons, experts say.

New federal work requirements for Medicaid, slated to come into effect on 1 January, mean that adults enrolled through the Affordable Care Act (ACA) Medicaid expansion will have to work, attend school, volunteer, or take part in another qualifying activity at least 80 hours a month to maintain their coverage.

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