Valued Voice

State Medicaid officials will hold a public webinar on Thursday, October 22, at 2:00 p.m. to discuss implementation of a new federal Medicaid work requirement enacted as part of the One Big Beautiful Bill Act.

Registration is required. To register for the state webinar, click here.

Starting next year, certain new applicants and existing Medicaid members will be required to meet federal work requirements to obtain or maintain health care coverage unless they qualify for an exemption.

The requirement applies to Medicaid members and applicants ages 19 through 64 who are not pregnant and do not have dependent children under age 19 living in their household.

About 200,000 adults subject to requirement, although exemptions apply

Approximately 200,000 Wisconsin adults enrolled in Medicaid are expected to be subject to the requirement, although several exemptions apply. Individuals who are medically frail, caring for a dependent child under age 14, or already subject to federal work requirements through the FoodShare program, among others, may qualify for an exemption.

In Wisconsin, the work requirement will apply only to BadgerCare Plus, the state's Medicaid program that provides health care coverage to low-income individuals and families. 

Adults enrolled in other Wisconsin Medicaid programs will not be subject to the requirement. Medicaid programs exempt from the work requirement include those providing home and community-based services, institutional Medicaid services, family planning services, emergency services and certain other categories of coverage.

Requirement generally needs to be met in only one month

To satisfy the requirement, non-exempt individuals must complete at least 80 hours in a month of work, volunteer service, community engagement or other qualifying activities. Unlike a monthly reporting requirement, individuals generally need to demonstrate compliance during only one month.

Beginning January 1, new applicants must demonstrate compliance during the month immediately preceding their application for coverage. Beginning with renewals due March 31, current Medicaid members must show they met the requirement at least once since their last eligibility determination, which for most enrollees will be within the previous 12 months.

Additional resources on the Medicaid work requirements, including the recordings and slides from two previous webinars held by Wisconsin Medicaid, are posted on the state Department of Health Services’ website here.