Medicaid expansion adults between 19 and 64 in Indiana, Idaho, South Dakota and Vermont will have to show 80 hours a month of work, school or community service beginning in 2027. Each state’s agency has set its own way in: some check the months before a person applies, others wait until a renewal comes up.
That timing matters more than the 80-hour number itself. In Indiana, a person who applies in January has to prove hours from October, November and December of 2026, so the clock for some applicants has already started. Anyone on expansion coverage in these states, or thinking of applying, needs to know which month counts first.
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How do the four states start the rule?
Indiana’s Family and Social Services Administration says the requirement for the Healthy Indiana Plan begins phasing in Jan. 1, 2027, for members 19 to 64 who are not exempt. The state uses a three-month lookback, so January 2027 applicants must show compliance in the three months before. Later applicants must show it for the three consecutive months ahead of applying.
Idaho’s Department of Health and Welfare says its reporting requirement takes effect Jan. 1, 2027, and applicants must meet it for three months before approval. Renewals happen twice a year, and recipients must verify their activity each time. The department is mailing letters to all affected households and says the changes stem from H.R. 1, the federal law Congress passed and President Trump signed last year. It also plans virtual town halls in the coming months, though dates have not been set.
South Dakota’s Department of Social Services lists a Jan. 1, 2027 start. A new applicant must show 80 hours in the month before applying, while a current enrollee is checked at the first regular renewal in 2027 and must show hours in at least one month since the last renewal. Vermont is staggered: its Department of Vermont Health Access page, updated Oct. 28, says applicants must meet the rule in the month before applying starting Jan. 1, and current members when they renew starting March 1, 2027.
What counts toward the 80 hours?
All four states let people combine activities. Indiana lists employment, job training, part-time education and community service, and South Dakota names work, job training, community or volunteer service, and school at least half-time. Vermont counts community service, education, work programs, jobs and self-employment.
There is also an earnings route. Indiana says earning at least $580 a month, or enrolling at least half-time in an eligible education program, also meets the requirement. Idaho lists working or earning at least $580 a month among its qualifying activities. Vermont accepts income of at least $580 a month, up to 138 percent of the federal poverty level, which its page puts at about $22,025 a year for one person.
Who is exempt from logging hours?
Each state publishes its own exemption list, and the lists overlap. Indiana names pregnancy, caregiving responsibilities, medical frailty, substance use disorder treatment and recent release from incarceration. South Dakota adds American Indians and Alaska Natives, veterans with a total disability rating, caregivers of a child 13 or younger or of a person with a disability, and people already meeting SNAP or TANF work rules.
Idaho’s list includes parents or main caregivers of a child 13 or younger, people who are blind, people with a disabling mental health condition and former foster youth ages 18 to 25. Vermont says its exemptions include caring for a disabled person or a child under 14 or having certain health conditions. Vermont’s page adds that people 65 and older, pregnant or postpartum, or enrolled in Medicare are not affected. A person who thinks an exemption fits should say so at application or renewal, since the states verify exemptions from their own data first. Idaho’s list also covers people who are incarcerated or were released within the last 90 days.
How do people report hours and keep their coverage?
Indiana says members can create a Benefits Portal account to report hours, upload documents and check exemptions, and that compliance is reviewed quarterly starting with available wage and program data. If hours cannot be confirmed electronically, a notice asks for documents. FSSA Secretary E. Mitchell Roob Jr. said in the release that “eligibility rests with each member.”
Idaho asks enrollees to keep their mailing address, phone number and email current and to sign up for alerts through the Idalink portal; its line for checking enrollment status is 1-877-456-1233. South Dakota says its department will use available data to verify hours and exclusions and will ask for more only if needed, with status shown in DSS notices or the BEES Customer Portal. Vermont’s customer service line is 1-855-899-9600.
People who lose Medicaid in South Dakota are pointed to the Health Insurance Marketplace at healthcare.gov. Keeping a simple monthly log of hours, pay stubs and any exemption paperwork gives a household something to hand over if a state notice arrives.
Will your 80 hours a month hold up for Medicaid in Indiana, Idaho, South Dakota or Vermont?
A missed notice or an hour log that does not match state records can put an expansion adult’s coverage at risk, and the lookback means some of the months that count come before the rule’s official start date.
The SNAP & Medicaid Renewal Organizer is a 20-page guide that covers the new Medicaid work requirement and who is exempt, and its 51 state packs and renewal calendar help a household keep its dates straight.
Get the organizer that explains the Medicaid work requirement and who is exempt →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
