Medicaid Work Rules Threaten Millions: Caregivers at Risk

Starting in January 2027, approximately 20 million low-income Americans across 42 states and Washington D.C. must meet monthly activity requirements to retain Medicaid health coverage. This measure, part of a larger budget law, is predicted by the Congressional Budget Office to reduce Medicaid enrollment by at least 5 million over the next decade. The law primarily targets "able-bodied adults," with exemptions for individuals with disabilities, caregivers, and those facing medical hardship.

However, experts warn that adults aged 50 to 64, especially women, are likely to be most impacted. Many in this demographic serve as family caregivers or manage chronic illnesses, making it difficult to meet the 80-hour monthly work quota. Research indicates only 8% of the total Medicaid population fits the "able-bodied" and unemployed criteria, with a significant portion being older women acting as caretakers.

Critics argue these work rules are a tool to cut costs at the expense of vulnerable individuals' lives, potentially worsening health outcomes by denying necessary care. Health policy researchers note that untreated chronic conditions in this age group could lead to higher costs for Medicare later. Caregiver advocates express concern that narrow exemptions will leave many, like full-time family caregivers, struggling to maintain coverage and facing crises.