What do people living with HIV need to know about
Medicaid Work Requirements?
Beginning on January 1, 2027, adults who are enrolled in Medicaid expansion programs must meet new federal work requirements unless they are exempt.[1] This fact sheet answers questions that many people with HIV have about the new requirement, to whom it applies, and how it works. If you are enrolled in Medicaid be sure to look for notices, keep your contact information up to date, check your portal or account if you have one, open mail/email/text messages from Medicaid, and check in with your Medicaid case worker and/or your Ryan White case manager periodically. If you live in AL, FL, KS, MS, SC, TN, TX, WY, or US territories, this new requirement does not apply to you.
How Can the Work Requirement be Met?
What Is the Medicaid Work Requirement?
A 2025 federal law requires adults aged 19-64 who are enrolled in a Medicaid expansion program to show that they are earning at least $580/month or engaging in work, school, or volunteering 80 hours/month, unless they are exempt from that requirement. It does not apply to “traditional” Medicaid, or in states that did not expand Medicaid (AL, FL, KS, MS, SC, TN, TX, WY). $580 is equal to 80 hours of work at the federal minimum wage ($7.25/hour). If you live in a state with a higher minimum wage, you still only need to earn $580 to meet the requirement.[2]
How Often Must I Show that I’ve Met
the Requirement or Am Exempt?
Do I Have to Meet the Work Requirement Every Month?
Are People with HIV or Hepatitis Exempt from the Requirement?
The AIDS Institute is a national non-partisan, nonprofit organization that promotes action for social change through public policy, research, advocacy and education. For more information and to become involved, visit www.TheAIDSInstitute.org or write to us at info@taimail.org, and follow The AIDS Institute on X @AIDSAdvocacy, Facebook at www.facebook.com/The-AIDS-Institute, and LinkedIn @the-aids-institute.
This brief was written by: Rachel Klein, The AIDS Institute
[1] A few states have opted to begin the requirement before January 1, 2027. Arkansas, Georgia, Iowa, Montana, and Nebraska have already begun requiring work reporting in Medicaid.
[2] See TAI fact sheet Medicaid Work Requirement Hourly Burden by State, https://www.theaidsinstitute.org/research-reports-and-analyses/fact-sheet-medicaid-work-requirement-hourly-burden-by-state
[3] Except American Indian/Alaska Natives, renewed annually.
[4] KFF, Tracking Implementation of the 2025 Reconciliation Law Medicaid Work Requirements, https://www.kff.org/medicaid/medicaid-work-requirements-tracker-state-national-data-and-policies/