since then states have been trying to build out the infrastructure and processes that connect health and employment records so they can comply with a new law when it goes into effect january 1st 2027 this month june 2026 the center for medicare and medicaid services the agency that manages medicaid sent guidance that enrollees must meet work requirements if they do not have significant medical impairments no definition of what that might mean the new standard has thrown states including maryland into a tizzy trying to figure out the transition morgan henderson is a senior director of analytics and research at the hilltop institute at umbc which assists the maryland department of health figure out these issues

Medicaid work requirement applies not to all Medicaid enrollees.

This applies to individuals in what's called the Affordable Care Act adult expansion.

Basically, those individuals that gained Medicaid eligibility by virtue of Medicaid expansions from the Affordable Care Act about 12, 13 years ago.

And big picture, these are basically childless adults with incomes up to 138% of federal poverty.

So before the ACA, to get Medicaid, you had to be basically a kid or a very, very low-income parent or caretaker.

We're talking a couple thousand dollars a year in income.

How can that happen if there's work requirement?