# US federal Medicaid work requirement implementation > Live situation record from CLSTR: https://clstr.news/situations/us-federal-medicaid-work-requirement-implementation > Updated: 2026-10-01T17:59:43.000Z. Sources: 21. Developments: 7. New federal Medicaid work and reporting requirements, stemming from legislation signed in July 2025, are scheduled to take effect on January 1, 2027. The rules mandate that most eligible adults aged 19 to 64 demonstrate qualifying activity—such as 80 hours of work, community service, or participation in work programs—or meet specific income standards to maintain coverage. As the October 1 implementation date for certain HR 1 provisions approaches, changes to the public charge rule and Medicaid eligibility may disqualify immigrants in states like Connecticut from programs such as HUSKY Health. Specifically, starting October 1, 2026, adults aged 19 and older who are not U.S. citizens or lawful permanent residents will lose Medicaid eligibility, causing financial fear among refugee families regarding the loss of healthcare and food assistance. In New York City, health officials estimate that up to 900,000 of the city’s 3.6 million Medicaid enrollees could face coverage termination. The NYC Department of Health and Mental Hygiene has launched an outreach campaign providing resources in 13 languages to assist citizens. Nationally, data suggests over 281,000 legal immigrants across several states and D.C. may lose coverage due to shifting eligibility conditions. While New York State has committed to using state funds to continue coverage for refugees and some asylum seekers, the specific insurance plans may change. Legal challenges are intensifying. In Maryland, a federal lawsuit contests the interpretation of the medical-frailty exemption under the One Big Beautiful Bill Act (OBBBA). Plaintiffs argue the narrow requirements for demonstrating significant impairment may strip coverage from those with serious but fluctuating illnesses. ## Timeline ### 2026-10-01: Medicaid eligibility changes threaten coverage for thousands in US New federal Medicaid rules involving work requirements and funding shifts threaten coverage for hundreds of thousands of Americans, including up to 900,000 residents in New York City. 2 sources. https://clstr.news/cluster/medicaid-eligibility-changes-threaten-coverage-for-thousands-in-us ### 2026-09-29: Medicaid medical frailty rules face legal challenge New CMS guidance on Medicaid medical frailty exemptions faces legal challenges as federal rules require patients to prove their conditions significantly impair their ability to meet upcoming work requirements. 3 sources. https://clstr.news/cluster/medicaid-policy-changes-face-legal-challenges-and-impact-eligibility ### 2026-09-28: Medicaid faces funding cuts and new work requirements Medicaid faces significant shifts due to federal funding changes and new work requirements. While some states increase dental reimbursements, others face cuts, and Nebraska reports coverage losses. 3 sources. https://clstr.news/cluster/medicaid-faces-funding-cuts-and-new-work-requirements ### 2026-09-25: Medicaid eligibility and work requirements face major changes under HR 1 New federal mandates under HR 1 are introducing Medicaid work requirements and changing eligibility for immigrants, sparking legal battles and projected shifts in national healthcare coverage. 8 sources. https://clstr.news/cluster/medicaid-eligibility-and-work-requirements-face-major-changes-under-hr-1 ### 2026-09-23: Medicaid work requirements trigger coverage concerns in Nebraska and Illinois As various U.S. states prepare to enforce Medicaid work requirements, officials warn of potential mass disenrollment and increased costs for local governments and healthcare systems. 2 sources. https://clstr.news/cluster/medicaid-work-requirements-trigger-coverage-concerns-in-nebraska-and-illinois ### 2026-09-21: Medicaid work requirements set to affect millions of Americans New federal Medicaid work requirements effective January 1, 2027, could impact 10 million Americans, prompting the launch of the ‘Keep Your Care’ campaign to assist recipients with compliance. 2 sources. https://clstr.news/cluster/medicaid-work-requirements-set-to-affect-millions-of-americans ### 2026-09-02: Wisconsin prepares for new Medicaid work requirements Wisconsin will implement new Medicaid work requirements in 2027, affecting BadgerCare Plus applicants. Officials warn 63,000 people could lose coverage under the new federal rules. 2 sources. https://clstr.news/cluster/wisconsin-prepares-for-new-medicaid-work-requirements --- Cite as: US federal Medicaid work requirement implementation. CLSTR, https://clstr.news/situations/us-federal-medicaid-work-requirement-implementation