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Some conservative states aren’t using Medicaid hardship exemption – for political reasons

States like Missouri and Iowa are choosing to not take up exemption designed to help low-income people keep coverage during hardship

Some conservative states that have rejected hardship exemptions for the new Medicaid requirements may be choosing not to due to political reasons, experts say.

New federal work requirements for Medicaid, slated to come into effect on 1 January, mean that adults enrolled through the Affordable Care Act (ACA) Medicaid expansion will have to work, attend school, volunteer, or take part in another qualifying activity at least 80 hours a month to maintain their coverage.

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© Photograph: Matthew Holst/Getty Images for MoveOn

© Photograph: Matthew Holst/Getty Images for MoveOn

© Photograph: Matthew Holst/Getty Images for MoveOn

Election calculator: Who will control the Senate after the midterms?

18 October 2026 at 05:00
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The battle for the Senate in the midterm elections will determine how much room Donald Trump has to maneuver during the second half of his term: no legislation reaches the White House without first passing through the upper chamber.

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