New Medicaid work rules taking effect starting next January will likely hit middle-aged adults—particularly women—harder than younger populations. Some 20 million low-income Americans in 42 states and Washington, D.C., will need to meet activity requirements to gain or keep Medicaid health coverage. The requirements mandate working, volunteering, attending school, or performing other qualifying activities for at least 80 hours a month.
The nonpartisan Congressional Budget Office predicts the work rules will result in at least 5 million fewer people with Medicaid coverage over the next decade. The Department of Health and Human Services says requiring “able-bodied adults” to work ensures Medicaid’s “long-term sustainability” while safeguarding it for the vulnerable. Exempt are people with disabilities, caregivers, pregnant and postpartum individuals, veterans with total disabilities, and others facing medical or personal hardship.
Impact on Middle-Aged Women
Medicaid covers 1 in 5 Americans ages 50 to 64, giving them access to health coverage before qualifying for Medicare at age 65. Among women on Medicaid, those ages 50 through 64 are more likely to face challenges keeping their coverage than their younger female peers and are likely to have a greater need for health care services. These middle-aged women are less likely to be working the required number of hours because many serve as family caregivers or have illnesses limiting their ability to work.
Researchers found that just 8% of the total Medicaid population is considered “able-bodied” and not working. This group consists largely of women who are very poor and have left the workforce to become caretakers. Among this group, 1 in 4 are 50 or older. Making it harder for people to maintain Medicaid coverage may actually undermine their ability to work because their health problems go untreated, according to Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at KFF. Adults often start wrestling with health issues before they are eligible for Medicare at 65.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.dailypress.com/2026/02/24/new-medicaid-work-rules/