Sponsors (5)
The bill ties Medicaid eligibility to proving 80 hours of work/service, aiming to encourage work and reduce improper payments but risking substantial coverage losses, administrative complexity, and privacy/error harms that disproportionately affect vulnerable people.
Low-income adults who meet the 80-hour work/earnings or service requirement retain Medicaid coverage, creating a clearer work incentive and potentially improving employment outcomes for beneficiaries who can comply.
State governments can remove noncompliant beneficiaries from Medicaid rolls, which can reduce improper payments and lower some state Medicaid spending and associated costs.
Low-income adults who fail to verify 80 hours risk losing Medicaid coverage, increasing uninsured rates and raising health care costs for those individuals and the health system.
People with intermittent work, irregular hours, or unstable housing will disproportionately lose coverage because they may be unable to meet or document the 80-hour requirement.
Individuals with disabilities or chronic health conditions may be incorrectly classified as noncompliant if medical determinations or exemptions are delayed, putting essential benefits at risk.
Based on analysis of 2 sections of legislative text.
Imposes an 80-hour/month Medicaid community engagement requirement for many adults, allows states to disenroll noncompliant people, and denies federal matching funds for noncompliant months.
Creates a new Medicaid "community engagement" requirement for many non‑elderly, non‑disabled adults receiving Medicaid: most adults would need to do 80 hours per month of work, community service, or a work program (or earn the equivalent at the federal minimum wage) to keep federal matching funds for their medical coverage. If an eligible adult fails the requirement for three or more months in the same year, the federal government would not provide matching funds for their Medicaid coverage for months they remain noncompliant, and states would be allowed to disenroll those individuals for months without federal matching. The law also defines who is exempt (children, seniors, pregnant people, parents/caretakers of dependent children, people medically unfit for work, half‑time students, and certain program participants), sets verification priorities, and creates administrative mechanisms for implementing the requirement and withholding Federal Financial Participation (FFP).
Introduced February 13, 2025 by Aaron Bean · Last progress February 13, 2025