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The federal government had planned to require poor adults to prove they were working or lose insurance coverage starting Jan. 1. Now, it will let states wait until July.
Nov. 13, 2026, 6:10 p.m. ET
The Trump administration will allow states to delay enforcement of new rules requiring low-income adults to work in order to receive Medicaid coverage, according to a letter it sent on Friday to state Medicaid directors.
The announcement, which followed a recent loss in court over a key element of the work requirement, represents a major setback for a long-sought Republican reform. It comes less than two months before the work requirements were set to begin, on Jan. 1. States can now wait until July before ending coverage for people who do not meet the work requirement, the letter said.
In the letter, Dan Brillman, who oversees Medicaid at the Centers for Medicare and Medicaid Services, acknowledged the significant burden states faced in building out new, expensive software systems to track the employment of enrollees. Hospitals have prepared massive education campaigns to help patients navigate the additional paperwork.
“We have heard directly from states about their implementation timelines, impediments to successful launches at scale,” Mr. Brillman wrote in the letter.
He added that the federal government still expected states in January to begin checking whether Medicaid enrollees are working. But for six months, they will not be required to cancel coverage for people who fail to comply, Mr. Brillman said.
The work requirement was enacted in the summer of 2025 as part of Republicans’ major tax and domestic policy legislation. It requires Medicaid enrollees without disabilities or young children to prove they worked, volunteered or attended school at least 80 hours a month in order to qualify for the program or continue enrollment in it.
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