Medicaid work requirement exemptions: who qualifies, and how to claim one

Under the new law (H.R.1), many adults on Medicaid must report about 80 hours a month of work, school, job training, or volunteering — unless they qualify for an exemption. Many people are exempt and don't know it, and lose coverage over paperwork they never had to file. Here are the exemption categories, in plain language, and exactly how to claim one.

Check if you're exempt → How to report hours
The categories

Who is exempt from the Medicaid work requirement?

If any of these describe you, you most likely do not have to report work hours — but you should still claim and confirm the exemption with your state so it's on record.

Caregivers

Parent or caretaker of a child under 14

If you care for a child under 14 — or another dependent who needs your care — you're generally exempt.

Pregnancy

Pregnant or postpartum

Members who are pregnant or recently gave birth are generally exempt during pregnancy and the postpartum period.

Medical

Disability or medically frail

A disability, a serious physical or behavioral health condition, or being medically frail is generally an exemption.

Treatment

In substance-use-disorder treatment

If you're getting treatment for a substance-use disorder, that's generally an exemption while you're in treatment.

Tribal

American Indian / Alaska Native

American Indian and Alaska Native members are exempt from the work requirement.

Students

Enrolled at least half-time

Students enrolled at least half-time generally qualify for an exemption.

Hardship

Short-term hardship

Some short-term hardships (for example, a recent hospitalization, a natural disaster, or homelessness) may qualify for a temporary exemption. These vary by state.

Already meeting it

Working / in school 80+ hrs a month

If you already do about 80 hours a month of work, school, training, or volunteering, you usually just need to report it. Here's how →

The most important step

How to claim a Medicaid exemption

  1. Identify which category fits you from the list above (or use the free "Am I exempt?" checker).
  2. Contact your Medicaid health plan or state Medicaid office. Tell them your situation. Your state may already have it on file — confirming gets your exemption recorded.
  3. Provide any documentation they ask for (for a medical or treatment exemption, this might be records from the state or a provider).
  4. Keep using your Medicaid. Never stop based on an online tool — only your state can confirm your status, and dropping coverage you're entitled to is hard to undo.
Why this matters: The last time work requirements ran (Arkansas, 2018–19), roughly 18,000 people lost coverage — most for procedural reasons like missed notices and unclaimed exemptions, not because they failed to work. An exemption only protects a member the state can identify. Claim it.
FAQ

Common questions about Medicaid exemptions

Who is exempt from the Medicaid work requirement?

Common categories under H.R.1: caretakers of a child under 14 (or a dependent), pregnant and postpartum members, people with a disability or who are medically frail, people in substance-use-disorder treatment, American Indian and Alaska Native members, students enrolled at least half-time, and people facing a short-term hardship. An exemption only protects a member the state can identify and document — so claim it.

How do I claim a Medicaid work-requirement exemption?

Contact your Medicaid health plan or state Medicaid office and tell them your situation. They may already have it on file, but confirming gets your exemption recorded. Don't stop using your Medicaid while you confirm.

Is being a caregiver an exemption?

Yes — parents and caretakers of a child under 14 (or a dependent who needs care) are generally exempt and usually don't report work hours. Still claim and document it.

Are pregnant women exempt?

Yes — pregnant and postpartum members are generally exempt. Claim and confirm it with your state.

What if I have a disability or medical condition?

A disability, serious medical condition, or medical frailty is generally an exemption. Documentation may be needed; only the state can confirm.

Will I lose Medicaid if I don't claim an exemption?

Possibly — many eligible people lose coverage for procedural reasons. If you're exempt but the state hasn't recorded it, you could be asked to report hours or lose coverage. Claim and confirm it, and never drop coverage based on a tool alone. More on what happens if you don't report →

Go deeper

Related guides & tools

"Am I exempt?" checker

Answer a few plain-language questions, in English or Spanish.

Open the tool →

Your state's rules

Implementation status, exemptions, and timeline by state.

50-state tracker →

The timeline

Key 2026–2027 dates and deadlines to watch.

Work requirements explained →

Get the Medicaid work-requirement updates that matter.

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For Medicaid health plans & state agencies

Exemption education that keeps eligible members enrolled.

This is the plain-language, multilingual exemption education we build and run for plans and states — so eligible members claim the exemption they qualify for instead of churning over paperwork.

For health plans → For state agencies →