As Medicaid work requirements loom, officials seek to inform enrollees
[September 24, 2026]
By Sean Reed | The Center Square
(The Center Square) – As new work requirements for Medicaid enrollees
take effect in roughly 100 days, elected officials are ramping up
efforts to inform residents of what changes they may soon face,
including potentially losing coverage.
As a result of the One Big Beautiful Bill Act, the Illinois-administered
federal program will soon be required to impose new work requirements of
80 hours per month, alongside other changes potentially making less
people eligible for the federally funded health insurance program.
Cook County officials said in a news conference Wednesday that as people
fall off the Medicaid rolls, the changes are also going to cost the
county increasingly each year after they take effect.
Cook County Board President Toni Preckwinkle said the new changes are
going to impact many residents in the largest Illinois county.
“One in five Americans, 20% of our population, relies on Medicaid for
health coverage. The Congressional Budget Office estimates these changes
will leave millions, millions of people uninsured,” Preckwinkle said.
She also said that the changes to the program won’t have the intended
effect of saving the government from having to pay as much for the
program, but rather it’ll shift the costs onto lower levels of
government.
“These costs do not disappear. They're shifted to states, local
governments, hospitals, and ultimately families. When people lose
coverage unnecessarily, they're more likely to delay care, go without
medications, and allow health conditions to worsen,” Preckwinkle said.
During the conference, Preckwinkle and other county commissioners
explained that until new work requirements take effect, they seek to
inform residents who will remain eligible, but are at risk of losing
coverage due to a more complicated system.
Illinois Department of Health and Family Services Director Elizabeth
Whitehorn said her department’s strategy as the Medicaid changes take
effect include plans to assist residents that will remain eligible,
ensure the program continues covering a vast variety of medical
services, and “mitigate harm to customers and providers.”
[to top of second column]
|
She noted some other changes take effect sooner.
“We're just a week away from the first major HR1 eligibility change
taking effect. On October 1st, approximately 9,300 Illinois Medicaid
customers will lose coverage because HR1 removes Medicaid
eligibility for certain lawfully present immigrants,” Whitehorn
said.
Dr. Mehmet Oz, administrator of the Centers for Medicare and
Medicaid Services, explained why he sees the work requirements as
beneficial.
“Congress, very wisely said, ‘let’s get you back into the workforce.
Let’s require you – to get free healthcare coverage – to be able to
work 20 hours a week, or volunteer, or get an education. Just
participate.’ If you can work, you should get up and work again,” Oz
said at a White House press briefing in June.
In a recent ranking of every state’s Medicaid program
implementation, Illinois was ranked 31st in the nation, mostly due
to its expanded spending, previous lack of work requirements and
expansion of the program from what congress originally created.
The state spent about $43.17 billion during the 2026 fiscal year
that ended July 31. Spending was up $6.11 billion from FY 2024,
according to state comptroller data.
For every dollar spent by the state on Medicaid, the federal
government reimburses about 51.82%.
The program changes in work requirements do provide some exemptions,
including for people with medical conditions preventing them from
working, persons with disabilities, and those who already meet SNAP
food assistance work requirements.
The changes to the program will take effect Jan. 1, and will be
applicable to any new applications received after Dec. 31 at 5 p.m.
Current Affordable Care Act adult customers will have to verify they
meet the work requirements once every six months, beginning in March
to redetermine if enrollees are still eligible.
 |
