If you rely on Medicaid for your health coverage, there are some big changes you need to know about. Over 80 million people in the U.S. depend on this program, and while funding is secure for now, upcoming laws and policy changes could reshape how Medicaid works—and who qualifies.
We’ve gathered the most important updates about work requirements, coverage cuts, and what you can do to protect your benefits in the months ahead.
Medicaid Funding Is Safe Through 2025
Even if the federal government shuts down, Medicaid payments will continue—for now. The Centers for Medicare & Medicaid Services (CMS) confirmed that it has enough advance funding to keep payments going through December 31, 2025. That covers the first quarter of fiscal year 2026, which starts in October 2025. This funding also ensures that programs like the Children’s Health Insurance Program (CHIP) will continue operating during that time.
Work Requirements Pushed to 2027
One of the most talked-about changes to Medicaid has been the introduction of work requirements. Originally, states like Indiana planned to start requiring most Medicaid enrollees to work, study, or volunteer in order to keep their coverage by mid-2026. However, the federal government has stepped in and told states they need to wait until 2027.
Although the law allows work requirements to begin “no later than December 31, 2026,” federal officials have clarified that states must wait until January 2027. This delay gives states more time to prepare and will prevent thousands of people from losing their health coverage prematurely.
New Technology, Texts, and AI—But Does It Work?
Some states are already testing new technologies to help people verify work activity and meet future requirements. Louisiana tested a text message system to help people confirm income and employment, but only 7% of participants completed the process. Trust issues, lack of awareness, and concerns about scams were some of the biggest hurdles.
CMS leadership has promised faster, mobile-first systems that could make verification easier, but many experts are skeptical. A recent investigation found that pilot programs haven’t shown clear results or explained exactly how these tools work. Most of the systems only confirm employment income and don’t account for other qualifying activities like school or community service. With the clock ticking down to the end of 2026, states have limited time to fix these issues.
Georgia Moves Forward with Its Own Work Requirement
Georgia is currently the only state implementing a Medicaid work requirement, thanks to a special waiver. The program, known as Pathways to Coverage, is expensive to run and has low enrollment. Despite millions of taxpayer dollars spent, only about 8,000 of the 100,000+ eligible residents have enrolled. Much of the program’s funding has gone toward administrative costs rather than direct healthcare services, and many people are being kept out due to confusing application processes.
Some States Are Cutting Medicaid Coverage and Programs
Budget pressures are forcing states to scale back or cancel some Medicaid programs, even ones that were saving money and improving health outcomes.
North Carolina is ending its Healthy Opportunities Pilot, which provided Medicaid patients with essentials like food, housing, and transportation. This innovative program actually saved about $1,000 per person per year and had strong bipartisan support, but it is ending due to funding constraints.
Oregon has canceled its planned Medicaid coverage for people recently released from prison. Although the re-entry program had not yet launched, it was cut because the waiver was temporary and the state didn’t believe it could get the system up and running in time.
Minnesota is temporarily pausing payments on 14 different Medicaid programs for 90 days as it investigates widespread fraud by service providers. The pause affects services like autism treatment, non-emergency transportation, personal care assistance, and mental health care. These payment delays target providers, not patients, but may still cause interruptions in care for some people.
Upcoming Medicaid Changes: What to Watch For
There are several important dates approaching that could impact your coverage:
- October 1, 2026: Medicaid eligibility ends for some lawfully present immigrants.
- December 31, 2026: Work requirements begin, and eligibility redeterminations will happen every six months.
- January 1, 2027: The retroactive coverage period will be shortened.
It’s more important than ever to keep your contact information up to date. If your address, phone number, or email changes, make sure your Medicaid office has the new information. Missing a notice or deadline could result in a loss of coverage—even if you’re still eligible.
If you do receive a letter saying your Medicaid has been denied or cut off, don’t panic. Read the letter carefully. It must include a reason and usually includes instructions for how to appeal. File your appeal before the deadline. If you miss it, you can still reapply. And if you need help, reach out to legal aid, health navigators, community health centers, or your Area Agency on Aging.
Relief Recap
Medicaid isn’t going away, but it is changing—and not always for the better. While funding is secure for now, upcoming work requirements, stricter eligibility checks, and state-level program cuts could lead to more people losing coverage in the coming years.
Staying informed and prepared is your best defense. Update your contact info, pay attention to letters from your state Medicaid office, and don’t hesitate to ask for help navigating these changes. We’ll keep tracking these developments so you know exactly what to expect and how to protect your benefits.
Are people with a disability an exception/exempt?
Great question! In general, Medicaid work rules apply to able-bodied adults, so people with disabilities are usually exempt. If you receive SSDI, you’re automatically exempt—but if not, you may need to provide proof of your disability to qualify.