Medicaid Work Requirements Coming in 2027Starting Jan. 1, 2027, most North Carolina adults aged 19 to 64 will have to work, study, or volunteer at least 80 hours a month to keep their Medicaid coverage. Enrollees can also satisfy the rule by earning at least $580 a month before taxes, roughly 80 hours at the federal minimum wage. Those who don’t meet it or don’t qualify for an exemption could lose benefits. Exemptions cover a long list, including parents of children under 14, pregnant women, people with disabilities, veterans rated fully disabled, and enrollees in substance-abuse treatment. The changes flow from H.R. 1, the federal budget law President Trump signed in July 2025. Democrats in about half the states have sued over the work rules. North Carolina expanded Medicaid in 2023, and nearly 735,000 residents have enrolled since then. Six-month renewals and shorter retroactive coverage also take effect in 2027. |
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