Updated

Montana started enforcing Medicaid work requirements on October 1, 2026, ahead of the national rollout scheduled for January 1 in most other states. Patients report confusion and anxiety over the new rules, which require proof of employment, volunteering, or schooling to maintain coverage. The early implementation in Montana is being watched closely as a test case for how the broader national Medicaid work-requirement policy, part of the recent Republican budget bill, will play out.