U.S. Social Safety Net

CBS, drawing on KFF Health News, reports that under a recently enacted GOP budget law, roughly 20 million low‑income adults in 42 states and Washington, D.C., will, starting in January 2027, have to log at least 80 hours a month of work, volunteering, school or similar “qualifying activities” to gain or keep Medicaid coverage. The Congressional Budget Office estimates the new work requirements will result in at least 5 million fewer people on Medicaid over the next decade, making them the largest single driver of coverage losses in the law that also cuts nearly $1 trillion to offset tax breaks and added border spending. Although Republican leaders publicly framed the policy as targeting “able‑bodied” younger adults, experts like KFF’s Jennifer Tolbert say older adults ages 50–64—especially women with health limitations or unstable jobs—are likely to be hit hardest, despite some exemptions for people with disabilities, caregivers, pregnant and postpartum women, certain veterans and others facing serious hardship. An HHS spokesperson, Andrew Nixon, defended the rules as necessary for Medicaid’s “long‑term sustainability,” while critics, including gerontology researcher Jane Tavares, argue they are primarily a cost‑cutting tool that will push vulnerable people off coverage and into worse health and deeper financial strain. The article situates the change in the broader trajectory of Medicaid expansion as a pre‑Medicare lifeline for millions of older adults and notes that eight non‑expansion states will not be subject to the new requirements, further widening interstate disparities in access to care.