Sponsors (4)
The bill trades increased state flexibility to tie Medicaid eligibility to work or volunteer activity and continuity for compliant enrollees against significant risks of coverage loss, administrative hurdles, and worsened health and cost burdens for vulnerable low‑income people who cannot meet or verify the 20‑hour requirement.
Low-income, able-bodied adults who meet a 20-hour per week work or volunteer requirement retain Medicaid coverage and continuity of care.
State governments gain flexibility to condition Medicaid eligibility on work or volunteer participation, which may encourage employment or community engagement and allow states to tailor programs to local labor markets.
Low-income adults who cannot meet the 20-hour/week requirement — including parents, caregivers, people with intermittent illnesses, and some people with disabilities — risk losing Medicaid coverage, reducing access to medical care.
Monthly verification and enforcement of work/volunteer hours will increase administrative burden for states and beneficiaries, raising the risk of wrongful coverage loss due to paperwork errors or reporting delays.
Forcing or pressuring people with intermittent health problems or unverified disabilities into work/volunteering can worsen health outcomes and compromise adequate treatment for those not formally exempted.
Based on analysis of 2 sections of legislative text.
Allows states to deny Medicaid to certain adults who fail a monthly 20-hour-per-week work-or-volunteer requirement beginning Jan 1, 2026.
Introduced February 6, 2025 by Daniel Crenshaw · Last progress February 6, 2025
Allows states to impose a monthly work-or-volunteer requirement for certain non-elderly, non-disabled adults on Medicaid and to deny Medicaid coverage to those who do not meet it starting January 1, 2026. Defines the requirement as averaging at least 20 hours per week of paid work or volunteer service and lists specific groups who are excluded from being subject to the rule.