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In certain U.S. states, proposed and limited Medicaid work requirements are putting freelance and gig workers in a precarious position. These workers could risk losing access to health coverage. It’s not because they aren’t working, but because they struggle to prove they are.
Some states have sought federal approval to implement rules that require Medicaid recipients to verify they work at least 80 hours per month to remain eligible for benefits. While the stated goal is to promote employment, these policies often ignore the nature of today’s decentralized and irregular workforce. For freelancers, gig workers and part-time employees, providing proof of consistent work hours can be challenging.
Irregular work and inconsistent records undermine access
Gig workers—think rideshare drivers, freelance creatives or app-based delivery workers—rarely follow traditional schedules. While one month may include 120 hours of work, another might come in just shy of 80. Income can fluctuate dramatically, and hour-by-hour logs are often unavailable.
Employers typically use platforms to track workers’ time and issue payments. These rarely include breakdowns of hours worked. Most freelance platforms issue lump-sum payments with no accompanying pay stub or breakdown of hours worked. Workers might receive a weekly or monthly statement of earnings, but these
