Ann Intern Med
Medicaid work requirements could cut coverage for up to 50% of beneficiaries
Clinical takeaway: Expect more patients cycling on and off Medicaid next year and beyond. Plan for medication gaps, delayed care, and closer follow-up in medically vulnerable patients.
A new analysis estimates that 50.4% of Medicaid beneficiaries (about 8.3 million adults) could be at risk of losing coverage under national work requirements. Those at risk were more likely to report poor physical and mental health, along with higher levels of physical, cognitive, and functional impairment—despite not qualifying for disability exemptions.
These findings suggest that coverage loss may disproportionately affect patients with chronic disease, neurocognitive limitations, and reduced functional capacity, rather than healthier populations. For clinicians, this translates to increased risk of medication interruptions, delayed care, and worsening disease control.
Medicaid work requirements are expected to be implemented as early as January 2027, depending on the state. Federal guidance for state implementation is anticipated in mid-2026.
Source: Vyas DA, et al. (2026, March 31). Ann Intern Med. Functional status of adults at risk of Medicaid disenrollment under national work requirements