Under the Medicaid community engagement requirements created by H.R.1, many adults aged 19 to 64 will need to document at least 80 hours of qualifying activity each month to keep their coverage. Enforcement begins January 1, 2027, but states will start sending notices during the June 30 to August 31, 2026 window. Knowing how to report correctly now is the single best way to avoid losing coverage for a paperwork reason rather than a real one.
What counts toward the 80 hours
Qualifying activities are broader than just a traditional job. In most states the 80 monthly hours can be met through paid employment, self-employment, community service or volunteering, participation in a work program, or enrollment in school or a job-training program at least half-time. Hours can also be combined: 40 hours of part-time work plus 40 hours of approved coursework in the same month generally meets the threshold. The key is that each hour must fall into a category your state recognizes, and you must be able to show it happened.
Before you report, gather proof. Pay stubs, a signed letter from a volunteer coordinator, a class schedule, or a self-employment log all work. Keep these even after you report, because states can ask you to verify later.
The reporting steps
First, find your reporting deadline. Most states require you to report monthly, typically by a fixed day of the following month. Second, choose your method: the online member portal is fastest and gives an instant confirmation, but phone and mail options exist and are covered in a separate guide. Third, enter the activity type, the number of hours, and the dates. Fourth, attach or reference your documentation if the system asks for it. Fifth, and this is the step people skip, save your confirmation number or screenshot. That confirmation is your proof that you reported on time.
If your income is already on file because you receive a paycheck through a reporting employer, some states will auto-verify your hours and you may not need to report manually. Do not assume this applies to you. Check your state's notice and, if in doubt, report anyway. A duplicate report never hurts you; a missing one can end your coverage.
The Arkansas experience from its earlier work requirement is the cautionary tale: roughly 18,000 people lost coverage in a matter of months, and about one in four enrollees subject to the rule were disenrolled, largely because they did not know how or when to report rather than because they failed to work. Reporting on time, every month, with a saved confirmation, is how you stay on the right side of that statistic.