# 10 million face Medicaid loss in 100 days

> New work requirements kick in January 1st, and advocates are racing to help people understand what they need to do to keep coverage.
- Title: 10 million face Medicaid loss in 100 days · NBC News
- Summary: New work requirements kick in January 1st, and advocates are racing to help people understand what they need to do to keep coverage. Starting January 1st…
- Keywords: medicaid, work requirements, healthcare coverage, trump administration, virginia, keep your care campaign, caregivers, health policy, affordable care act expansion, administrative burden, politics, news
- Source: NBC News — https://nbcnews.com/politics/politics-news/new-campaign-help-millions-risk-losing-medicaid-work-requirements-rcna598149
- Author: Julie Tsirkin
- Published: 2026-09-23T09:00:41+00:00
- Read time: 1 min
- Topics: medicaid, work requirements, healthcare coverage, trump administration, virginia, keep your care campaign, caregivers, health policy, affordable care act expansion, administrative burden, politics, news
## 100 days until Medicaid rules change
On January 1st, new federal work and reporting requirements take effect for Medicaid, putting roughly 10 million Americans at risk of losing healthcare coverage.
## Campaign launches to help people navigate change
A new $2 million campaign called Keep Your Care launched Wednesday to educate states and Medicaid recipients about the new requirements before they take effect.
## Most adults must work 80 hours monthly
The new requirements mandate that most eligible Medicaid adults work or perform community service for at least 80 hours per month to maintain coverage.
## Caregivers face extra paperwork burden
Full-time caregivers are exempt from work requirements but must prove their exemption every six months, creating administrative hurdles that could cause people to lose coverage by mistake.

> Once it leaves us and goes to a Medicaid worker to process, that's where we are concerned they're going to miss a deadline or fall through the cracks.
## Republicans say rules target waste
Republicans passed the work requirements as part of legislation signed by President Trump, arguing they eliminate waste and fraud while protecting eligible recipients.

> What we're talking about here is getting rid of waste, fraud and abuse, strengthening and improving the program.
## Advocates warn of coverage losses
Healthcare advocates argue the administrative complexity will cause eligible people to lose coverage through no fault of their own, calling it a predictable consequence of the new rules.

> I go back to just look at the debate that allowed this bill to pass. This is a predictable surprise.
## One family's struggle with caregiving
Greg and Melanie Stephens quit their jobs to care for their disabled daughter Rachel full-time. Without Medicaid, they say Rachel would need institutional care, which they believe would harm her.

> There's no one that could possibly care for her medically, or emotionally or cognitively. She would have no will to live.
## Campaign targets seven key states
Keep Your Care is focusing on Georgia, North Carolina, Illinois, Michigan, California, Virginia and New York, where millions could lose coverage under Medicaid expansion.
## Key takeaway

Starting January 1st, Medicaid recipients must meet new work or reporting requirements or risk losing coverage, affecting roughly 10 million Americans.