Resolution criteria:

This market will resolve to "Yes" if there is a federal law or regulation in effect in 2026 that mandates employment or work-related activities as a condition for Medicaid eligibility for able-bodied adults without dependents. The market will resolve to "No" if no such federal requirement is in effect by that date.

Background:

Medicaid is a joint federal and state program providing health coverage to low-income individuals. Historically, eligibility has been based primarily on income, without federal work requirements. However, there have been periodic efforts to introduce work requirements:

• State-Level Initiatives: During the Trump administration, several states received approval to implement work requirements for Medicaid enrollees. For instance, Arkansas introduced such requirements in 2018, leading to approximately 18,000 individuals losing coverage before a federal judge halted the program in 2019. (kffhealthnews.org) As of early 2025, Georgia is the only state actively enforcing Medicaid work requirements, with other states like Arkansas and Ohio seeking to reintroduce or implement similar policies. (revcare.com)

• Federal Proposals: In 2023, House Republicans passed a debt ceiling bill that included provisions for Medicaid work requirements, aiming to reduce federal spending and promote employment. The Congressional Budget Office estimated that such requirements could save $109 billion over a decade but might result in 600,000 adults becoming uninsured. (fiercehealthcare.com) While this bill did not become law, it indicates ongoing interest in federal work requirements for Medicaid.

Considerations:

• Legal Challenges: Previous attempts to implement Medicaid work requirements have faced legal obstacles. For example, Arkansas' program was halted by a federal judge in 2019. (kffhealthnews.org) Any future federal mandates may similarly encounter legal scrutiny.

• Administrative Feasibility: Implementing work requirements involves significant administrative efforts, including tracking compliance and managing exemptions. States like Georgia have faced challenges in rolling out such programs, leading to considerations of scaling back certain elements. (kffhealthnews.org)

• Political Landscape: The adoption of federal work requirements for Medicaid is influenced by the political composition of Congress and the administration. Changes in leadership and policy priorities can impact the likelihood of such requirements being enacted.

Recent Developments in Medicaid Work Requirements:

• Republicans weigh cuts to Medicaid that could dramatically affect millions

• Republicans consider cuts and work requirements for Medicaid, jeopardizing care for millions

• What Republican Work Requirements in the Debt Ceiling Bill Would Do