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News
New Medicaid work requirements could leave millions uninsured. A Boston University study published in JAMA Health Forum finds that nearly 1 in 5 Medicaid-eligible adults in expansion states — up to 10 million people — risk losing coverage because their jobs offer inconsistent or insufficient hours. Low-wage workers, single mothers, and those with undiagnosed health conditions are among the most vulnerable.
A new study from Boston University, published in JAMA Health Forum, warns that as many as 10 million Medicaid-eligible adults in expansion states could lose their health coverage once national work requirements take effect on January 1 under the One Big Beautiful Bill Act. The requirements mandate that enrollees work at least 80 hours per month — a threshold that sounds straightforward but proves tricky for many low-wage workers in retail, hospitality, food service, and agriculture, where hours are often unpredictable and hard to control.
Researchers analyzed 2023–2025 Current Population Survey data and found that while about two-thirds of applicable Medicaid recipients are in the labor force, real-world barriers — including transportation challenges, childcare gaps, and undiagnosed health conditions — make consistent compliance difficult for a significant share of enrollees.
By the Numbers:
Why it matters: Losing Medicaid coverage doesn't just affect health — it can also undermine the very ability to work. Researchers note that stable insurance helps enrollees manage health conditions that, when untreated, make steady employment harder to maintain, creating a difficult cycle that the new requirements may worsen.
