A major federal policy change to Medicaid work and reporting requirements, effective January 1, 2027, could threaten coverage for about 10 million Americans according to the article.

Virginia couple Melanie and Greg Stephens, who care full-time for their disabled daughter Rachel, face new rules that will exempt them from the 80-hour-per-month work requirement but require six-month recertifications for their exemption, highlighting ongoing administrative burdens for caregivers.

To mitigate impact, a new independent nonprofit campaign Keep Your Care, backed by the Service Employees International Union and advocacy groups, aims to educate states and Medicaid recipients about changes, exemptions, and key reporting deadlines, focusing on seven Medicaid expansion states: California, Georgia, Illinois, Michigan, New York, North Carolina, and Virginia.

Critics and health care experts describe the policy as a significant barrier to access, with Virginia Health Secretary Marvin Figueroa calling the potential losses a predictable outcome of the changes.

The broader concern is that tens of millions could lose coverage or experience disruptions due to administrative red tape, despite proponents arguing the bill targets waste, fraud, and abuse rather than cutting Medicaid.