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Confusion and Angst Follow State's Early Rollout of Medicaid Work Rules

The state health department will enforce new eligibility rules as federal Medicaid changes take effect, with officials saying about 30% of adult enrollees may be affected.

  • On Thursday, October 1, Montana begins enforcing new Medicaid work requirements, affecting nearly 71,000 enrollees who must document 80 hours of work, volunteering, or study monthly.
  • Montana is among three states adopting these requirements months ahead of the federal deadline, following a 2019 state legislature measure expressing desire to add work requirements.
  • Confusing departmental notices have created anxiety for enrollees like Bethany Zulick, who received conflicting deadlines instructing her to submit proof "within 30 days" of the letter date, fueling fears of unnecessary coverage loss.
  • Staffing shortages compound concerns, with only about 20 of 59 positions filled; Aaron Wernham, CEO of the Montana Healthcare Foundation, stated the state's rushed approach leaves him "much more worried about chaos."
  • Akeiisa Coleman, an analyst for The Commonwealth Fund, warned Montana's rollout serves as a "potential preview" for the nation, as most states aim for a January 1 deadline to build and test systems.
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The Billings Gazette broke the news in Billings, United States on Monday, September 28, 2026.
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