Medicaid work rules take effect in some states before January deadline

New Medicaid work requirements have begun in some states and are scheduled to be implemented nationally by Jan. 1, NBC News reported. The rules matter because experts cited by NBC News warn that paperwork and reporting demands could cause millions of people to lose coverage, including some who remain eligible.

The mandate was passed last year as part of the Trump administration’s bill known as the “big, beautiful bill,” according to NBC News. It requires some Medicaid participants to work, volunteer or attend school for at least 80 hours each month.

NBC News reported that the requirements have already rolled out in some states, including Nebraska. The policy is set to reach the rest of the country by the start of the year.

The rules apply to some Medicaid patients in states that expanded eligibility under the Affordable Care Act, according to NBC News. The mandate does not cover every enrollee. NBC News reported that certain groups, including people who are pregnant or medically frail, are exempt.

Health policy experts have warned, according to NBC News, that the new system could place a heavy administrative load on state agencies. Their concern is that people may lose Medicaid not because they fail to meet the underlying rules, but because they struggle with documentation, reporting deadlines or other procedural hurdles.

NBC News said it is seeking to hear from patients, medical providers and health care advocates about how the changes are affecting them. The outlet is asking people subject to the work requirements, and those who know someone at risk of losing coverage, to share their experiences.

The request comes as states begin applying the new mandate and preparing for broader implementation. NBC News said it is focusing on how the policy is affecting patients, providers and communities as the January deadline approaches.

This story draws on original reporting from NBC News.