You may have heard about changes to Medicaid that could make it harder for people to get or keep Medicaid coverage.
As many as 2 in 3 Medicaid beneficiaries could lose coverage not because they’re ineligible, but because of confusing new paperwork, red tape, and new deadlines.
Caring Across Generations is working to help families stay covered and navigate these changes through Keep Your Care, which provides clear, accessible information to Medicaid beneficiaries at zero cost.
Here’s what you need to know about these changes, why they’re happening, who is at risk, and what you can do to protect your coverage:
What’s happening to Medicaid and why?
Medicaid is the program that provides health and long-term care to roughly 80 million people in the United States.
In July 2025, Congress passed, and the President signed, the One Big Beautiful Bill Act, which cut nearly $1 trillion from Medicaid.
To cut federal Medicaid spending, the new law requires many adults with Medicaid to prove they’re working or doing another approved activity, like going to school or volunteering, to get or keep their coverage.
This primarily impacts adults ages 19 to 64 who get Medicaid through their state’s expansion program – which helps make sure that more people with the least resources have medical overage. Many of these folks are already working or caring for a family member, but they could still lose coverage if they miss paperwork or deadlines.
Experts estimate that up to 15 million people could be at risk of losing Medicaid because of these new rules, even though most of them are working or should qualify for an exemption.
The new rules start in every state by January 1, 2027, and some states start even earlier.
I’m not sure if I’m on Medicaid. How do I find out?
Medicaid goes by different names in different states. For instance, in California, it’s called Medi-Cal. In Michigan, many adults are covered through the Healthy Michigan Plan (HMP).
Look up what Medicaid is called in your state.
To check whether you’re enrolled:
– Look for a Medicaid card or letter from your state
– Log in to your state’s Medicaid website, if you signed up online.
– Call your state Medicaid office. Find their contact information here.
What are the new work requirements? Are my family and I at risk?
The new rules apply to adults ages 19 to 64 in most states who are enrolled in Medicaid. If this includes you, you’ll need to show that you meet the requirement, or that you’re exempt, to get or keep your care.
To meet the requirement, you’ll need:
– At least 80 hours per month of work, job training, school or community service (any combination counts), or
– Earnings of at least $580 a month
The work requirement doesn’t apply to you if are:
– A parent or caregiver of a child 13 or younger
– Pregnant or recently gave birth
– A caregiver for someone with a disability
– A person with a disability or serious health condition as well as some disabled people, and pregnant and postpartum people.
Even if the requirement doesn’t apply to you, you may still need to prove it.
Depending on your state, you might have to send in paperwork showing you’re in one of these groups, or that you’re meeting the requirement. Don’t assume you’re covered automatically.
I’m already working — do I still have to do anything?
In most cases, yes. In some cases, your state may be able to confirm your work on its own, but you’ll likely need to show proof, like pay stubs, to keep your Medicaid coverage.
Don’t assume you’re covered automatically! Many people who may lose their Medicaid under these new requirements will not lose it because they don’t qualify, but because of a missed a form or deadline.
What happens if I lose coverage?
Before your coverage ends, your state has to send you a notice and give you time to fix the problem.
If you do lose coverage, you can apply again once you can show that you meet the requirement or that it doesn’t apply to you.
Act as soon as you can. A gap in coverage can mean going without care or paying out of pocket. And if you lose Medicaid because of these rules, you can’t get financial help to buy a plan on the ACA marketplace instead.
Find your state Medicaid office’s contact information here.
Does this affect my kids’ coverage?
Not directly. Children under 19 on Medicaid or Children’s Health Insurance Program (CHIP) don’t have to meet the work requirement. But it may affect you as a parent or caregiver.
If your youngest child is 14 or older, the work requirement may apply to you. And if your child is 19 or older, the requirement may apply to them too.
Find help with Medicaid and CHIP in your state.
Get updates on Medicaid work requirements + share your story
Stay up-to-date on the latest with Medicaid work requirements, helpful resources, and more by signing up to receive emails here.
Share your story: How are Medicaid work requirements affecting you? Share your story to help us show what’s at stake and protect access to care.