Will the 2027 Medicaid work rules affect you?

A 3.4-million-enrollee expansion state — and one of the states suing over the rule

HealthChoice Illinois — ACA Adult (MAGI) expansion

The longest-running active Medicaid work requirement in the country

Georgia Pathways to Coverage

The first state enforcing the OBBBA work requirement — denials have begun

Nebraska Medicaid (Heritage Health Adult expansion)

Fully enforcing since October 1, 2026 — the grace period has ended

Montana Medicaid expansion (HELP Act)

The state that ran the 2018 experiment — 18,000 lost coverage

ARHOME (Arkansas Health and Opportunity for Me)

A ballot-measure expansion state where the 2027 requirement lands on a large, recently enrolled population

MO HealthNet (Adult Expansion Group)

Non-expansion state: no work requirement applies — but one of the largest coverage gaps in the country

Florida Medicaid (no adult expansion)

Non-expansion state: no work requirement applies — but the largest coverage gap in the nation

Texas Medicaid (no adult expansion)

Non-expansion state with a work-requirement history: TennCare sought a waiver years before it was federal law

TennCare (no adult expansion)

Enforcement begins December 1, 2026 — the next state to watch

Iowa Health and Wellness Plan (Medicaid expansion)

The newest big expansion — 600,000+ enrollees facing their first work rules

NC Medicaid (expansion)

Three-quarters of a million expansion adults and an early-implementation signal

Ohio Medicaid (Group VIII expansion)

HIP 2.0 already ties coverage to member behavior — and FSSA has published a January 1, 2027 start

Healthy Indiana Plan (HIP 2.0)

Healthy Michigan's 700,000 adults — and a January 2027 start date the state has now published

Healthy Michigan Plan

The original HELP waiver state — the legal fight that shaped every later program

Kentucky Medicaid (expansion via kynect)

A high-poverty, high-churn expansion population — and an administration eager to move

Louisiana Medicaid (expansion)

The largest Medicaid program in the country has to layer the federal 80-hour rule onto more expansion adults than any other state

Medi-Cal

SoonerCare expanded in 2021 — one of the newest expansion states — and now takes on the same 2027 federal deadline as the founding states

SoonerCare

Apple Health expanded on the first day of the ACA — and Washington already knows how to run engagement-focused waiver programs

Apple Health (Washington Apple Health)

The Oregon Health Plan was a first-day ACA expansion — 2027 adds monthly hour-tracking to a mature, data-driven program

Oregon Health Plan (OHP)

Centennial Care expanded in 2014 and covers children to 300% FPL — one of the most generous children's programs in the country

Centennial Care (New Mexico Medicaid)

The unusual case: Wisconsin never expanded Medicaid, yet BadgerCare Plus covers adults up to 100% FPL — no coverage gap, and no 2027 work requirement

BadgerCare Plus

Alabama is one of the strictest non-expansion states: parents qualify only up to about 13% FPL, among the lowest in the country, and childless adults are not co

Alabama Medicaid

Alaska expanded in September 2015 and uses higher federal poverty guidelines than the lower 48 — the dollar figures on this site (computed for the 48 contiguous

Alaska Medicaid

Arizona runs Medicaid through AHCCCS — one of the oldest Medicaid managed-care programs in the country, in operation since 1982.

Arizona Health Care Cost Containment System (AHCCCS)

Colorado brands its Medicaid expansion as Health First Colorado, and its separate Children's Health Plan Plus (CHP+) also covers pregnant women up to 260% FPL.

Health First Colorado

Connecticut was an early expander (2010 under a waiver) and brands its Medicaid HUSKY A and its separate CHIP HUSKY B under one HUSKY Health umbrella.

HUSKY Health

Delaware delivers Medicaid through the Diamond State Health Plan managed-care program and covers children in Medicaid to 212% FPL, with a separate Delaware Heal

Delaware Medicaid (Diamond State Health Plan)

Hawaii covers children up to 308% FPL inside Medicaid — among the highest children's ceilings in the CMS table — and administers everything through the Med-QUES

Med-QUEST

Idaho expanded in January 2020 by voter-approved ballot measure, and its expansion adults are a relatively young population on Medicaid timelines.

Idaho Medicaid

Kansas is a non-expansion state with a parents standard around 33% FPL, leaving a sizable coverage gap; its Medicaid is branded KanCare and delivered through th

Kansas Medicaid

Maine expanded in October 2019 after a voter-approved ballot measure was implemented by court order, and covers children up to 300% FPL inside MaineCare.

Maine Medicaid

Maryland covers children up to 317% FPL in Medicaid — one of the highest children's ceilings in the country — under the Maryland Children's Health Program (MCHP

Maryland Medicaid

Massachusetts has near-universal-coverage DNA: it runs MassHealth (which includes the CHIP-funded children's expansion to 300% FPL) and also covers 19- and 20-y

MassHealth

Minnesota covers adults up to 200% FPL through MinnesotaCare — a Basic Health Program — above the 138% Medicaid expansion line, so its adult coverage story goes

Minnesota Medical Assistance

Mississippi is a non-expansion state with a parents standard around 19% FPL — one of the lowest in the country — and one of the poorest populations; its separat

Mississippi Medicaid

Nevada expanded on day one of the ACA and runs its Medicaid through the Division of Health Care Financing and Policy, with the Nevada Check Up separate CHIP to

Nevada Medicaid

New Hampshire expanded in August 2014 and uses the Granite State's existing Medicaid Care Management program for expansion adults.

New Hampshire Medicaid

New Jersey runs Medicaid and CHIP as one integrated program — NJ FamilyCare — covering children to 350% FPL, among the highest in the country.

NJ FamilyCare

New York covers children to 400% FPL through Child Health Plus — the highest children's ceiling in the CMS table — and covers adults 138-200% FPL through the Es

New York Medicaid

North Dakota expanded in January 2014 and delivers Medicaid through Sanford and other managed-care plans under the ND Medicaid brand.

North Dakota Medicaid

Pennsylvania expanded in January 2015 and runs its separate CHIP to 314% FPL alongside Medicaid's all-ages children's coverage.

Pennsylvania Medicaid

Rhode Island was an early expander and covers pregnant women through both Medicaid (190%) and a CHIP-funded pregnancy coverage to 253% FPL.

Rhode Island Medicaid

South Carolina is a non-expansion state that brands its Medicaid Healthy Connections; parents qualify up to about 62% FPL and childless adults are not covered a

South Carolina Medicaid

South Dakota is the newest expansion state, covering expansion adults only since July 2023 — the shortest runway to the 2027 federal requirement of any expansio

South Dakota Medicaid

Utah partially expanded in April 2019 and completed full ACA expansion in January 2020, with enrollment capped at 138% FPL.

Utah Medicaid

Vermont brands children's Medicaid Dr. Dynasaur (covering children to 312% FPL) and adult coverage Green Mountain Care; it was an early ACA expander.

Vermont Medicaid (Green Mountain Care)

Virginia expanded in January 2019 and rebranded its Medicaid and CHIP as Cardinal Care in 2025 — children's FAMIS coverage folds into the same brand.

Cardinal Care

West Virginia expanded early and aggressively — it has one of the highest Medicaid enrollment rates in the country — and covers children to 133% in Medicaid plu

West Virginia Medicaid (Mountain Health Trust)

Wyoming is a non-expansion state with a parents standard around 45% FPL and no coverage for childless adults; it has no separate CHIP program.

Wyoming Medicaid