States face tight timeline as feds unveil new Medicaid work requirement rules

The federal government released new guidance for states to implement Medicaid work requirements, which will affect 20 million adults. States must comply with a January 1, 2027, deadline, but Democratic governors argue the timeline is unworkable. The requirements, part of the One Big Beautiful Bill Act, mandate 80 monthly hours of work, education, or community service for Medicaid eligibility in states that expanded coverage under the Affordable Care Act.