Trump Rule Would Leave Thousands of Latino Workers Without Health Coverage

A new federal rule will require many adults on Medicaid to demonstrate at least 80 monthly hours of work, study, training, or volunteering. The measure could complicate coverage for thousands of Latino agricultural workers with temporary jobs and informal income.

The requirement is part of the One Big Beautiful Bill Act, signed by President Donald Trump. Most states must implement it before January 1, 2027, though some could do so earlier.

The change affects people who already work but face difficulties documenting their hours. In agriculture, jobs typically depend on harvests, weather, and seasonal contracts.

What Changes with Medicaid in 2026?

Medicaid is a federal and state program that covers health services for low-income people. Each state administers the program with its own rules, within parameters set by the federal government. The new rule will require many enrolled adults to demonstrate 80 monthly hours of approved activity. That activity can include employment, college studies, vocational training, volunteering, or unpaid work.

The requirement will apply mainly in 43 states and Washington D.C. that expanded Medicaid under the Affordable Care Act, known as Obamacare. The change does not affect all beneficiaries equally. Some people will be exempt, for example, minors, seniors, people with certain disabilities, and those meeting other criteria defined by each state.

However, agricultural workers could face barriers even when exceeding the required 80 hours. The problem will not always be working, but presenting documents that prove that work. In many cases, agricultural activity is concentrated in a few months. Outside of season, some people work in gardening, construction, cleaning, or repairs with cash payments.

Why Does This Concern Agricultural Workers?

The United States relies on approximately 2.9 million agricultural workers to produce and harvest food. About 60% are U.S. citizens or legal permanent residents, according to Department of Agriculture data cited by KFF Health News. More than 1 million of those workers could meet immigration requirements for Medicaid. Still, many have temporary jobs, move between states, or alternate between formal and informal work.