Beginning January 1, 2027, most adults on Medicaid will have to demonstrate that they work at least 80 hours per month or participate in qualifying activities such as work, training, education, or volunteering[2][4]. States must implement these requirements by this deadline, although they may choose to implement earlier[2]. The federal government has set aside $200 million to help states with implementation costs in 2026, with $100 million to be split equally among all states and $100 million to be split by the number of individuals subject to the requirements[1][2]. However, according to the Government Accountability Office, implementation costs in five states with similar programs totaled $408 million, indicating that federal funding will be insufficient.[1] States will need to make significant changes to their computer systems, increase data sharing, and inform policyholders, which will require additional funding and personnel[3]. The Congressional Budget Office estimates that the implementation of work requirements will cause the loss of health coverage for 4.8 million people over the next ten years[2].