Final Rules for Medicaid Work Requirements Are Out. Here’s What You Need To Know.

The Trump administration issued final rules requiring Medicaid enrollees in certain states to prove they are working or engaged in qualifying activities like job training or education. The rules, part of the One Big Beautiful Bill Act, will affect roughly 18.5 million Medicaid expansion enrollees, with exemptions for children, pregnant people, individuals with disabilities, and those deemed medically frail. States are implementing systems to enforce the requirements, with some starting enforcement before the 2027 rollout.