Up to 7 million people could lose insurance as states face tight timeline for Medicaid work requirement rules

The federal government released guidance on implementing Medicaid work requirements, which could result in up to 7 million people losing insurance by 2027. States must verify work status for 20 million Medicaid enrollees, facing a tight deadline and criticism from governors who argue the timeline is unworkable. The policy, part of the One Big Beautiful Bill Act, requires adults in expanded Medicaid states to work or engage in approved activities for 80 hours monthly.