Texas Medicaid Work Requirements
Non-expansion state — requirement does not applyNon-expansion state: no work requirement applies — but the largest coverage gap in the nation
Texas 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.
No work requirement in Texas — and no expansion either
The direct answer to 'Texas Medicaid work requirement 2027': it does not apply in Texas. The federal 80-hour community-engagement rule covers adults enrolled through ACA Medicaid expansion. Texas never expanded, so there is no expansion group for the rule to reach. No Texan will receive an 80-hour compliance notice in 2027 because of this law.
That said, the 2026–2027 federal changes still touch Texas in other ways — redetermination processes, immigrant eligibility changes under OBBBA Section 71109, and marketplace subsidy rules all matter here. The work requirement just isn't one of them.
The largest coverage gap in the country
Texas has the highest uninsured rate in the nation, and its coverage gap is the biggest: adults without dependent children cannot qualify for Texas Medicaid at any income level, parents qualify only at extremely low income, and ACA marketplace subsidies begin at 100% of the federal poverty level. KFF estimates put the number of Texas adults in this gap in the hundreds of thousands — the largest of any state.
If you are in the Texas gap, the practical options are: documenting income above 100% FPL for marketplace coverage (gig, seasonal, and self-employment income can be averaged across months — see our $580/seasonal income guide), sliding-scale community health centers (Texas has a large FQHC network), and hospital financial-assistance policies, which nonprofit hospitals are required to publish.
What to watch in Texas
Texas has rejected expansion in every legislative session to date, and nothing on the horizon suggests a near-term change. If Texas ever did expand, the OBBBA work requirement would attach to the new expansion population from day one — expansion and work reporting now come as a package.
Meanwhile, the October 1, 2026 immigrant eligibility changes are highly relevant in Texas, which has one of the largest lawfully-present immigrant populations in the country. Refugees, asylees, parolees, and TPS holders on federally-funded Medicaid lose that eligibility; check our immigrant eligibility hub (English/Spanish) for your category.
Exemptions in Texas
OBBBA exemption categories apply to expansion adults only; Texas has no expansion adults. Existing Texas eligibility rules are unchanged by the work requirement.
Not applicable — no expansion work requirement in Texas. Disability-related Medicaid pathways continue under standard eligibility rules.
Exemption guides: medically frail · parent & caretaker · student · already meeting SNAP/TANF rules
Run the exemption self-checkDocuments to prepare
- ✓ Proof of income for all household members (pay stubs, employer letter, self-employment logs)
- ✓ Pregnancy verification if applying under pregnancy coverage
- ✓ Disability documentation if applying through a disability pathway
- ✓ Renewal forms returned on time — Texas procedural disenrollment rates are among the highest
- ✓ ACA marketplace application if income is too high for Texas Medicaid
Official Texas resources
Texas Health and Human Services Commission (HHSC)
Texas work requirement FAQ
Who is exempt from the Texas 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; Texas has no expansion adults. Existing Texas eligibility rules are unchanged by the work requirement.
What are Texas's Medicaid income limits?＋
Because Texas 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 Texas Health and Human Services Commission (HHSC).
Full 2026 Texas Medicaid income limits chart by family size →
What happens if I lose Medicaid in Texas?＋
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.
Does Texas have a Medicaid work requirement in 2027?＋
No. The federal 80-hour community-engagement requirement applies to ACA expansion-category adults, and Texas never expanded Medicaid — so no Texas Medicaid group becomes subject to the requirement in 2027. Existing Texas eligibility rules are unchanged.
If Texas has no work requirement, what is the real problem?＋
The coverage gap. Childless adults in Texas are ineligible for Medicaid at any income, and parents qualify only at extremely low income levels, while ACA marketplace subsidies start at 100% FPL. Texas has the largest coverage gap in the country — on the order of three-quarters of a million adults by KFF estimates — and the highest uninsured rate. The coverage alternatives guide linked on this page ranks the realistic options.
Could the work requirement ever reach Texas?＋
Only if Texas expands Medicaid. If the state ever adopts expansion, the OBBBA community-engagement requirement would attach to the new expansion population immediately — expansion in Texas would arrive with work reporting built in.
Is STAR the same as Texas Medicaid?＋
STAR is the managed-care delivery system for most of Texas Medicaid — you enroll in a STAR health plan, and the plan administers your Medicaid benefits. Children's Medicaid and CHIP are separate programs; because Texas has not expanded Medicaid, most adults without dependent children do not qualify at any income.
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Sources & verification
Reviewed by Gavin YE, Technical Director, ClearRules Labs.
Page last reviewed 2026-09-20
| Field | Status | Note |
|---|---|---|
| Non-expansion status | Verified | Confirmed against KFF expansion tracker and Texas HHSC |
| Agency, application portal & phone | Verified | Confirmed against hhs.texas.gov / yourtexasbenefits.com |
| Work requirement not applicable | Verified | OBBBA applies to expansion-category adults; Texas has none |
| Coverage gap size estimate | Pending | Estimates vary by year and methodology; see KFF for current figure |
- Texas Health and Human Services — Medicaid & CHIP — State of Texas (accessed 2026-09-07)
- Your Texas Benefits — Texas HHSC (accessed 2026-09-07)
- Status of state Medicaid expansion decisions — KFF (accessed 2026-09-07)
Page last verified 2026-09-20 · Status: verified-official (non-expansion; requirement not applicable). Estimates only — your state Medicaid agency's determination controls.