The new Medicaid work requirement, explained (2026)
The One Big Beautiful Bill Act (OBBBA) created a federal “community engagement requirement” for Medicaid. Starting as states roll it out in 2026 — most by January 1, 2027 — able-bodied adults aged 19 to 64 in the Medicaid expansion population must show at least 80 hours per month of qualifying activity to keep their coverage.
The good news: the hours combine across categories, lots of activities count, and a long list of people are fully exempt. This checker walks the same logic a state eligibility system would: it first looks at your age, then your exemptions, then your hours or income.
What counts toward the 80 hours
| Activity | Counts? |
|---|---|
| Paid employment or self-employment | Yes — hours worked |
| Community service / volunteering | Yes |
| Work program or job training | Yes |
| Education / enrollment in school | Yes |
| Earned income ≥ $580/month | Yes — income equivalent (80 × $7.25) |
Who is exempt
Any one of these removes the requirement entirely:
| Exemption |
|---|
| Under 19, or 65 and older |
| Pregnant or postpartum (within 60 days of birth) |
| Parent or caregiver of a child age 13 or under, or of a disabled dependent |
| Medically frail — disabled, blind, serious mental illness, or substance-use disorder |
| Member of a federally recognized Tribe / IHS-eligible |
| Already meeting SNAP or TANF work requirements |
| Incarcerated or released within the last 90 days |
| Receiving unemployment compensation |
What happens if you fall short
If the rule applies to you and you’re below 80 hours, you risk losing Medicaid coverage at your next eligibility check. States must give you a way to report hours, claim an exemption, or come back into compliance — so the practical advice is to track your hours every month and keep proof (pay stubs, volunteer logs, enrollment letters). This tool shows exactly how many more hours you’d need.
Frequently asked questions
What are the new Medicaid work requirements for 2026?
Able-bodied adults 19–64 in the Medicaid expansion group must complete at least 80 hours/month of work, community service, a work program, or education (hours combine), or earn at least $580/month. The rule comes from the OBBBA and takes effect as states implement it in 2026, with most live by January 1, 2027.
Who is exempt from the requirement?
Children/teens under 19 and adults 65+, pregnant/postpartum women, caregivers of a child 13 or under or a disabled dependent, the medically frail, Tribal members, people already meeting SNAP/TANF work rules, the recently incarcerated, and those on unemployment. Any single exemption applies.
Does going to school count?
Yes. Hours spent in education or a job-training program count toward the 80, and they stack with work and community-service hours.
Is this an official government tool?
No. Calcova is an independent estimator that applies the enacted OBBBA rules. Your state Medicaid agency makes the final determination and may ask you to document your hours or exemption.
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