Policy & Research · Texas behavioral health news
Medicaid Work Rule Leaves Homeless People in the Cold
KFF Health News – Mental Health · By Katheryn Houghton · August 6, 2026
In plain language
New federal rules require many people on Medicaid to prove they are working, volunteering, or in school to keep their health insurance. While some groups like pregnant people and those with disabilities are exempt, the federal government does not consider being homeless a reason to skip these requirements. This change is causing concern for people without stable housing who struggle with health issues, such as seizures or addiction. Without Medicaid, many may lose access to the prescriptions and specialty care they need to stay healthy enough to eventually return to work.
AI-generated summary of the source article. Not medical advice.
Key takeaways
- Federal regulations require Medicaid enrollees to prove they meet work or education requirements to keep their health coverage.
- The federal government has determined that being homeless does not qualify as an automatic exemption from work rules.
- Montana and several other states will begin implementing these strict eligibility checks as early as late 2026.
- People who are homeless but too sick to work must provide medical proof of their condition within a short timeframe.
- Advocates worry that losing health insurance will make it harder for vulnerable people to access addiction treatment and specialty care.
Conservatives who have long pushed for Medicaid work requirements often said vulnerable people would get a pass. But the federal government’s list of exemptions left off homeless people.
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