New federal law now requires most adults on Medicaid to document 80 hours of work or community engagement each month starting in 2027. Supporters hope the requirements will encourage participation and align Medicaid with other benefit programs. Many chronic disease patients share that goal.

But the details matter deeply.

Research shows that the majority of Medicaid enrollees are already working. Among those who aren’t, many face serious health barriers—conditions that limit their ability to hold a job, manage paperwork deadlines, or navigate a new reporting system. For people managing chronic illness, losing health coverage doesn’t make employment more likely. It makes it harder.

The Chronic Disease Coalition believes communities are stronger when everyone has access to the care they need to live, work, and thrive. We support smart, compassionate implementation of these new rules—with clear, workable exemptions for those who are medically fragile, and safeguards that prevent patients from losing coverage because of paperwork rather than policy.

Take 2 minutes right now to send a letter to your state and federal representatives.

Your experience matters. Tell elected officials what Medicaid coverage makes possible for you—your ability to work, parent, volunteer, and participate in your community. Remind them that protecting patients with chronic illness isn’t at odds with encouraging work and engagement. It’s what makes both possible.