Medicaid work rules diverge as states push longer look-back periods

Federal Medicaid rules require applicants to show at least one month of work, schooling, or volunteering to gain or keep coverage, but some states are pushing for longer look-backs. Indiana and Idaho have enacted three-month requirements, while others will opt for one month within the federal framework that lets states choose 1–3 months. The policy could affect about 18.5 million people nationwide, with concerns that stricter rules will reduce coverage for vulnerable residents and create barriers for those with nontraditional work. States vary in exemptions and how they implement the rules, resulting in a patchwork across the country.