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flag Up to 4.6 million Medicaid recipients in high-unemployment areas may be exempt from work rules if states apply for waivers.

flag Under President Trump's upcoming Medicaid work requirement, set for January 2027, millions of adult, nondisabled recipients in 42 states and D.C. must work, volunteer, or attend school 80 hours monthly to keep coverage. flag However, individuals in counties with unemployment rates at least 8% or 1.5 times the national average may be exempt if states apply for waivers. flag A KFF analysis suggests that up to 4.6 million people in 386 counties could qualify for relief if the administration uses a flexible interpretation, potentially exempting nearly a quarter of those affected. flag The rule applies only to states that expanded Medicaid or received special waivers, and the final number of exempt individuals depends on how the administration interprets the law and whether states formally seek exemptions.

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