Over 1 Million People May Avoid Trump's Medicaid Work Rules in Areas with High Unemployment

In the context of upcoming changes to Medicaid policies, recent analysis indicates that over a million enrollees could potentially be exempt from the new federal work requirements, especially those residing in counties experiencing high unemployment rates. Starting January 2027, many adult Medicaid enrollees in 42 states and Washington, D.C., will be expected to work, volunteer, or attend school for at least 80 hours monthly to maintain their benefits. However, these requirements are not universally applied. Enrollees living in counties with unemployment rates of 8% or higher—approximately 1.5 times the national average—may qualify for exemptions if their states apply for federal approval. The analysis by KFF estimates that around 4.6 million Medicaid recipients across 386 counties could be exempt under a threshold based on a one-month unemployment rate exceeding the law's limits, potentially affecting nearly a quarter of those subject to work mandates. When considering a stricter, 12-month average unemployment rate, about 1.4 million individuals in 158 counties, primarily in states like California, New York, Michigan, Kentucky, and Ohio, could be exempted—accounting for roughly 7% of affected enrollees. This provision is designed to ease the burden on those in areas where job opportunities are scarce, although the actual impact depends on state applications and federal decisions. Critics assume the law might be challenging to navigate, citing examples from Arkansas and Georgia where work requirements led to coverage losses or administrative complications. While some advocates appreciate the exemptions as a safeguard, others warn they may be underutilized due to political resistance or administrative hurdles, leaving many vulnerable to losing Medicaid coverage despite high unemployment conditions.

Source: https://medicalxpress.com/news/2025-10-jobs-scarce-million-people-dodge.html