Florida Lawmakers Aim to Add Work Requirements Without Expanding Medicaid

"You cannot change the terms of the work requirement. It's a pretty easy no. Federal law holds that non-expansion states cannot adopt work requirements under the One Big Beautiful Bill Act. Leo Cuello, an attorney and professor at Georgetown University's McCourt School of Public Policy, cites guidance from the Centers for Medicare and Medicaid Services in making this determination."

"Medicaid work requirements affect Washington, D.C., and the 40 states that have expanded Medicaid eligibility to all nondisabled adults ages 19 through 64 with incomes up to 138% of the federal poverty level, as prescribed under the Affordable Care Act. Starting next January, those states must require people in their expansion groups to report at least 80 hours a month of work, education, or community service."

Federal budget reconciliation law restricts work requirements to states that have expanded Medicaid under the Affordable Care Act. Florida, a non-expansion state, is uniquely attempting to adopt Medicaid work requirements anyway, making it the only legislative body in a non-expansion state to consider this policy. Legal experts and health care advocates question the legality of this move, citing Centers for Medicare and Medicaid Services guidance that prohibits changing work requirement terms in non-expansion states. Work requirements currently apply only to the 40 states plus Washington, D.C. that have expanded Medicaid, requiring beneficiaries to report at least 80 hours monthly of work, education, or community service starting January.

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