Cheryl Miller

Adults ages 19 to 64 in expansion coverage must complete 80 hours per mo through work, volunteering, school, or approved participation programs.
Nationally, a budget office projects requirements will apply to 18.5M enrollees, with 5.3M projected to lose coverage by 2034 as rollout proceeds across required states.
Enforcement began May 1, 2026, eight mo before the federal deadline; remaining required states are scheduled by January 1, 2027, unless extensions apply.
Exemptions include caregivers, totally disabled veterans, older adults, qualifying federal benefit recipients, pregnant or postpartum people, medically frail adults, foster youth, and eligible Indigenous members.
Protect coverage now: update contact details, monitor official mail through Late-Q3 2026, gather exemption records, and call your state office with questions.

US Public Coverage Work Rules Rollout

Federal retiree health coverage has usually excluded GLP-1 drugs for weight loss alone, while allowing coverage for certain qualifying medical conditions today.
In Early-Q3 2026, a temporary program is expected to let some retirees seek GLP-1 coverage when weight loss is the main goal.
Qualifying may require standalone drug coverage or a retiree health plan with drug benefits, doctor authorization, obesity documentation, and related health concerns too.
The short-term window is scheduled to close after 2027, while a longer-term model may expand access depending on the plan retirees choose.
Before the enrollment period, retirees considering GLP-1 medication should compare formularies, prior authorization rules, step therapy, and doctor documentation needs very carefully.