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Starting Jan. 1, 2026, most low-income adults must work, volunteer, or study 80 hours monthly to keep Medicaid, under new federal rules aimed at saving $388 billion.
Starting January 1, 2026, millions of lower-income adults in most U.S. states must work, volunteer, or study at least 80 hours monthly to maintain Medicaid coverage, under new federal rules tied to a major tax-cut law.
The changes, which require biannual eligibility reviews, aim to save $388 billion over ten years by reducing enrollment by 6 million people.
States face significant costs—projected to exceed $1 billion—to upgrade outdated computer systems, improve online portals, and verify participation, despite a $200 million federal aid allocation.
Many states rely on private contractors and lack centralized databases for volunteer or employment data, complicating implementation.
The federal government will cover up to 90% of system development costs but will penalize states with excessive payment errors starting October 2029.
A partir del 1 de enero de 2026, la mayoría de los adultos de bajos ingresos deben trabajar, ser voluntarios o estudiar 80 horas al mes para mantener Medicaid, según las nuevas reglas federales destinadas a ahorrar 388 mil millones de dólares.