Two states that start Medicaid work requirements on January 1, 2027 have named different exemptions. Utah excludes a parent, guardian or caregiver of a child age 13 or younger. Nevada’s list covers parents or caretakers of a child under 13, and also people on unemployment. A parent of a 13-year-old is excluded in Utah and not by the children’s category in Nevada.
Same start date, two separate lists
Both states begin the requirement on January 1, 2027 and aim it at adults 19 to 64. Utah Medicaid’s H.R. 1 site applies it to Adult Expansion Medicaid and Targeted Adult Medicaid. Nevada Current reports that Nevada’s applies to adults who qualify through the Affordable Care Act expansion.
The test is similar. Utah asks for 80 hours each month of work, job training, school at least half-time or volunteering, or earnings of at least $580 a month, or a showing of why the person cannot work or volunteer. Nevada requires verifying at least 80 hours of qualifying work, training, education or community service in a month.
In both states eligibility is reviewed every six months. Nevada says renewals used to come yearly. The groups named are not the same, so each list has to be read on its own terms. A caregiver in Salt Lake City and a parent in Las Vegas can hear similar words and land on different sides of the line.
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Utah’s nine exclusions, including 100 percent disabled veterans
Utah’s list names adults who are pregnant or on postpartum Medicaid, in foster care or formerly in foster care, American Indian or Alaska Native, and a parent, guardian or caregiver for a child age 13 or younger or for a person with a disability. That caregiver category is the one in the headline, and it reaches beyond children.
The rest of Utah’s list covers a veteran with a 100 percent disability rating, a person who is medically frail or has special needs, adults subject to work requirements in SNAP or TANF, people who are incarcerated, and people in a drug or alcohol treatment and rehabilitation program. That makes nine groups in all.
Current members can also count activity they have already completed. Utah says people enrolled in Medicare Part A or B, or receiving SSI, are treated as having met the rule, and a member needs to meet it in only one month since the last approval or renewal. Proof may be needed at each six-month review.
American Indian and Alaska Native members face a date of their own. Utah says verified status must be submitted by January 1, 2027 for the exemption to apply, and those members keep 12-month reviews. Accepted documents include a tribal enrollment card, a certificate of degree of Indian blood or an Indian Health Service face sheet.
Utah mailed members a letter about the requirement in July 2026. The state’s eligibility line is 1-866-435-7414. Its H.R. 1 site announces no delay, and says many changes will begin in late 2026 and phase in over several years.
Nevada’s list adds unemployment and sets the child line lower
Nevada Current reported on September 4 that the Nevada Health Authority had begun mailing notices on the new rule. The exempt groups it listed were pregnant and postpartum people, people with disabilities or serious medical conditions, parents or caretakers of a child under 13, people on unemployment, people in drug or alcohol treatment, and people who are incarcerated.
Two differences stand out. Utah’s list names no unemployment category, so a Utah adult who is out of work and in no listed group falls back on the 80-hour or $580 test, or on showing why work is not possible. Nevada names people on unemployment outright.
The child line differs by a year. Utah’s covers a child 13 or younger, which includes a 13-year-old. Nevada’s covers a child under 13, which stops at 12. For a family with a 13-year-old as the only child, the Utah caregiver is in a listed group and the Nevada parent is not, on the children’s category alone.
The Nevada Health Authority is sending about 250,000 informational letters, with text and email follow-ups through September. It says most people are expected to be excluded or to meet the rule already. It had earlier estimated about 280,000 Nevadans could be affected.
Nevada Medicaid Administrator Ann Jensen said the notices explain who is affected, what counts as community engagement, how to report compliance and how to request an exemption. “No one should lose coverage simply because they weren’t aware of the new requirement,” she said.
Other states publish their own lists too
Neither list is a national one, and other states word theirs differently. Illinois lists people who care for a young child or a dependent with a disability, without giving an age. Oklahoma’s SoonerCare notice lists no exemptions and points members to an online screener.
Whatever a state calls an exemption, it comes up again at renewal. Utah and Nevada both move expansion adults to six-month reviews from January 1, 2027, and Utah says members may need to provide proof at each one.
Is a Utah or Nevada exemption already on file?
An exemption that is true but not documented can still cost coverage at the first six-month review. Utah and Nevada both move expansion adults to renewals every six months from January 1, 2027, and a child’s age or a layoff date decides which list applies.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, with a renewal document checklist and a renewal and reporting calendar to track each six-month date. Its 51 state packs keep each state’s rules apart instead of blending them.
Get the renewal checklist and exemption guide for the Medicaid work rule →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
