Tennessee Medicaid Work Requirements
Non-expansion state — requirement does not applyNon-expansion state with a work-requirement history: TennCare sought a waiver years before it was federal law
Tennessee compliance calculator
Federal minimum wage: $7.25. Self-employed? Use your average hourly net earnings.
≈ 108 hours/month. The requirement is 80/month.
Pay stubs or an employer letter count.
Parents of children 13 or under, pregnant/postpartum women, people with disabilities or medical frailty, and several other federal categories are exempt. An exemption beats any hour-counting strategy — run the exemption wizard before optimizing hours.
At 25 hrs/week you average ~108 hours/month, above the 80-hour floor. You must document every month.
At $12.00/hour you need ~49 hours/month to reach $580. Your projected $1300/month clears it.
OBBBA lets hours from work, community service, job training, and education combine toward 80. Volunteering ~10 hrs/week (≈45 hrs/month) plus part-time work can close gaps that wages alone cannot.
Parents of children 13 or under, pregnant/postpartum women, people with disabilities or medical frailty, and several other federal categories are exempt. An exemption beats any hour-counting strategy — run the exemption wizard before optimizing hours.
Variable schedules can dip below 80 hours in slow months. Some states average hours over a period; until your state publishes rules, plan for the strict monthly reading.
The state that tried work requirements before they were federal
Tennessee holds a unique place in this story: in 2019 it became one of the first states to win federal approval for a Medicaid work requirement — structured to apply if Tennessee ever expanded Medicaid. Because expansion never happened, the waiver was never implemented. That history tells you something important: Tennessee's political leadership has wanted work reporting for years, and now that it is federal law for expansion states, Tennessee is a candidate for a future expansion-with-work-requirement combination.
For 2027 specifically, though, the answer for Tennesseans is simple: no 80-hour reporting applies, because there is no expansion population in the state.
Tennessee's coverage gap
Like other non-expansion states, Tennessee leaves a gap: childless adults are ineligible for TennCare at any income, parent eligibility is limited to very low incomes, and ACA marketplace subsidies start at 100% of the federal poverty level. Tens of thousands of Tennessee adults fall between those lines.
If you are in the gap, your realistic paths are marketplace coverage with income documented above 100% FPL (variable and seasonal income can be averaged — see our income-path guide), Tennessee's community health centers with sliding-scale fees, and hospital charity-care programs. Our alternatives page compares these options side by side.
What to watch in Tennessee
Tennessee is one of the most plausible 'next expansion' states precisely because of its work-requirement history: the 2019 approval gives the state a template, and the federal law now provides political cover. If Tennessee moves, coverage would arrive with the 80-hour rule attached from day one — and the state could enforce early, as Nebraska and Montana did.
The October 1, 2026 immigrant eligibility changes also affect Tennessee's lawfully-present immigrant communities — refugees, asylees, parolees, and TPS holders currently on federally-funded Medicaid lose that eligibility. Our immigrant eligibility hub covers each category in English and Spanish.
Exemptions in Tennessee
OBBBA exemption categories apply to expansion adults only; Tennessee has no expansion adults. Existing TennCare eligibility rules are unchanged by the work requirement.
Not applicable — no expansion work requirement in Tennessee. Disability pathways continue under existing TennCare rules.
Exemption guides: medically frail · parent & caretaker · student · already meeting SNAP/TANF rules
Run the exemption self-checkDocuments to prepare
- ✓ Proof of income for household members (pay stubs, employer letter)
- ✓ Pregnancy verification if applying under pregnancy coverage
- ✓ Disability documentation if applying through a disability pathway
- ✓ Renewal packets returned on time
- ✓ ACA marketplace application if income is too high for TennCare
Official Tennessee resources
TennCare — Tennessee Department of Finance & Administration, Division of TennCare
Tennessee work requirement FAQ
Who is exempt from the Tennessee work requirement?＋
Federal law exempts parents and caretakers of children under 14, pregnant and postpartum women, people receiving disability benefits, the medically frail, students enrolled at least half-time, former foster youth up to 26, and people already meeting TANF or SNAP work rules. OBBBA exemption categories apply to expansion adults only; Tennessee has no expansion adults. Existing TennCare eligibility rules are unchanged by the work requirement.
What are Tennessee's Medicaid income limits?＋
Because Tennessee has not expanded Medicaid under the ACA, most adults without dependent children do not qualify at any income — the coverage gap. Parents qualify only at very low income levels. Children, pregnant women and people with disabilities have separate eligibility categories with their own income limits, set by TennCare — Tennessee Department of Finance & Administration, Division of TennCare.
Full 2026 Tennessee Medicaid income limits chart by family size →
What happens if I lose Medicaid in Tennessee?＋
Losing Medicaid triggers a 60-day special enrollment period for ACA marketplace coverage, and children may qualify for CHIP even when adults do not. Our coverage alternatives guide ranks the realistic fallbacks — marketplace subsidies, employer coverage, CHIP and community health centers — by cost.
Is TennCare the same as Medicaid?＋
Yes. TennCare is Tennessee's Medicaid program, administered by the Division of TennCare. It covers children, pregnant women, very-low-income parents, seniors and people with disabilities. Because Tennessee has not expanded Medicaid, adults without dependent children are not covered at any income — that is the coverage gap, not a TennCare rule.
How does Tennessee Medicaid work?＋
TennCare covers children, pregnant women, parents at very low incomes, seniors and people with disabilities, each with its own income category. Applications and renewals run through TennCare Connect online or by phone (1-855-259-0701). Adults without dependent children are not eligible because Tennessee has not expanded Medicaid; if your income can be documented above 100% FPL, the ACA marketplace is the main alternative.
What does Medicaid cover in Tennessee?＋
TennCare covers the federal Medicaid benefit package: doctor and hospital care, prescriptions, behavioral health, and preventive and maternity care. Children get EPSDT screening benefits, which are broader than the adult package. For a personal benefit question, TennCare member services (1-855-259-0701) or your managed-care plan controls.
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Sources & verification
Reviewed by Gavin YE, Technical Director, ClearRules Labs.
Page last reviewed 2026-09-28
| Field | Status | Note |
|---|---|---|
| Non-expansion status | Verified | Confirmed against KFF expansion tracker and TennCare |
| Agency, application portal & phone | Verified | Confirmed against tn.gov/tenncare and tenncareconnect.tn.gov |
| 2019 work-requirement waiver history | Verified | Documented in CMS waiver records; never implemented (no expansion) |
| Work requirement not applicable 2027 | Verified | OBBBA applies to expansion-category adults; Tennessee has none |
- TennCare — official program site — State of Tennessee (accessed 2026-09-07)
- TennCare Connect — State of Tennessee (accessed 2026-09-07)
- Status of state Medicaid expansion decisions — KFF (accessed 2026-09-07)
Page last verified 2026-09-28 · Status: verified-official (non-expansion; requirement not applicable). Estimates only — your state Medicaid agency's determination controls.