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Home » News » Medicaid work rules return in key states

Medicaid work rules return in key states

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  • Digital Team 
Congress is considering major Medicaid cuts that could change eligibility and coverage. Here’s what’s in the bill and who could be impacted.

At least a dozen states are pushing to bring back Medicaid work requirements, reviving a policy that could cut coverage for hundreds of thousands of low-income adults in 2025.

The push is gaining traction despite court battles and federal pushback in past years. In states like Georgia and Mississippi, the rules are already active or approved to begin this year.

Where work requirements are taking effect

Georgia’s “Pathways to Coverage” program, launched in July 2023, requires Medicaid recipients to work, volunteer, or attend school at least 80 hours per month. Failure to meet these conditions results in immediate loss of coverage.

Mississippi, Arkansas, and Kansas are expected to implement similar rules by the end of 2025. At least seven other states are preparing waiver applications or legislation.

Most of these plans apply only to able-bodied adults without dependents, but experts warn the rules can still create barriers for eligible participants.

What supporters say

Proponents argue that work requirements encourage employment and self-sufficiency. They say limited Medicaid resources should prioritize those actively contributing to the economy.

Georgia Governor Brian Kemp defended the state’s approach, calling it “a balanced plan that promotes personal responsibility while expanding access.”

What critics warn

Healthcare advocates and public policy researchers warn the rules could push many off the rolls unnecessarily. Complex paperwork, job instability, or a lack of internet access could make it hard for eligible recipients to comply.

In Arkansas, a similar program removed over 18,000 people from Medicaid in just a few months before courts blocked it in 2019.

A study from the Kaiser Family Foundation found that most Medicaid recipients who can work already do, but many still face job volatility or caregiving responsibilities that don’t meet narrow state definitions.

Federal response remains uncertain

The Biden administration has rejected several work requirement waivers since 2021, but courts have recently ruled that the federal government cannot unilaterally revoke previously approved programs.

This legal ambiguity has opened the door for new efforts in conservative-led states, where lawmakers are testing the limits of federal oversight.

What to watch next

The U.S. Supreme Court may weigh in if legal challenges continue. Meanwhile, states like Georgia are serving as real-world test cases for how these policies impact coverage, employment, and healthcare access.

Key takeaways

  • At least 12 states are reviving or proposing Medicaid work requirements in 2025.
  • Georgia’s program is already active and removes coverage for noncompliance.
  • Critics say the rules will cause eligible people to lose healthcare.
  • Legal battles may ultimately decide how far states can go.
  • Millions could be affected depending on implementation.

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