Beneficiaries must work or volunteer at least 80 hours per month, attend school at least part-time, or participate in job training.
Trump issues final rule requiring most Medicaid beneficiaries to work
Story by Nathaniel Weixel
Trump issues final rule requiring most Medicaid beneficiaries to work
A new final rule from the Trump administration will require most Medicaid beneficiaries between the ages of 19 and 64 to prove they work, complete community service, or participate in a work program to win benefits.
The rule outlines the broad policies each state is required to have in place when implementing the Medicaid work requirements from the One Big Beautiful Bill Act.
The rule establishes the standards states must use to implement the statutory work requirement, including clear expectations for eligibility determinations, exemptions, verification, and state reporting requirements.
The GOP’s tax and spending megabill passed by Congress last summer used work requirements to partially pay for its nearly $3 trillion price tag. The Congressional Budget Office estimated nearly 5 million people will lose their Medicaid over the next decade as a result, including many who are already working.
GOP officials argue work requirements are needed to root out waste, fraud and abuse in the Medicaid program, and they will only target the “able-bodied” people who should be working but choose not to.
The work requirements have to begin by January 1, 2027. The new rule gives states some flexibility in determining who is exempt from the work requirements, but many of the exemptions are already defined in the law.
For instance, states will be able to define who is “medically frail” but they will need to have specific verification requirements in place after a year to verify both the presence of a condition or diagnosis, and that the condition or diagnosis significantly impairs the individual’s ability to comply with the community engagement requirement.
“This is our path to prosperity for the American people. It’s a way to preserve our precious Medicaid program for those who benefited from it,” CMS Administrator Mehmet Oz told reporters during a briefing.
“We hope by guiding able-bodied individuals in this initiative, we aim to support their path to independence, but hopefully they don’t need to depend on Medicaid, and are supported by employer-sponsored health plans that would free up critical space in the program forour most vulnerable population to receive the care they deserve,” Oz said.
Trump’s signature tax cut law that he signed in July requires all 42 states, along with the District of Columbia, that fully or partially expanded Medicaid under ObamaCare to implement a “community engagement” requirement.
Beneficiaries must work or volunteer at least 80 hours per month, attend school at least part-time, or participate in job training. Or they must prove they qualify for certain exemptions, like caring for a child 13 years or younger or a disabled parent, or having a health condition that prevents employment.
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