Work Requirements for Insurance
Summary: La discusión en el hilo 'Work Requirements for Insurance' parece incluir intercambios entre diferentes participantes, como coxreads y stainlessenginecovers, entre otros, aunque los detalles específicos de su contenido no están presentes. Sin embargo, parece que hubo una interacción constante y respuestas múltiples entre algunos usuarios, sugiriendo que el tema puede haber sido discutido de manera detallada. Se mencionan respuestas repetidas y posibles idas y venidas entre participantes, mostrando un interés activo en el tema aunque no se puede determinar el contenido exacto de las discusiones. Sin embargo, el hilo denota que numerosos participantes estuvieron involucrados, intercambiando ideas posiblemente en torno al tema de los requerimientos laborales para seguros, aunque al final queda claro que gran parte de la información de contenido se omite.
The federal government will be requiring states to collect proof from their Medicaid participants that they are satisfying the work requirement that will allow them to keep their Medicaid (Meci-Cal, MaineCare, etc.). I am not sure how those of us who earn a living from selling online will be able to prove that we work at least 20 hours a week. Has anyone heard any new details about this? I have looked and I find nothing. Thanks!
P.S. This is not in reference to this eBay account. I have multiple shops on different platforms and between all of it, I do work very much. Thank you.
galacticbargain
·4 months agosomeone who works in the system said they speculate some states will do a 20 hours a week OR $$$ equivalent. Also they have a income limit for the program and i doubt that will be going away. I think the person said the $$ equivalent is 580$ a month but I'm not sure. Also ppl with self employment in the program are income determined differently so we shall see what happens.
meme6253
·4 months agoThis is a tough one!, But I think go-bad-chicken has the right ideas for you, Good Luck, let us know whatever you do find out, I am sure there are many who will be interested in this subject.
authentic*vintage
·4 months agoActually, self-employment like reselling or running an online store does count toward the work rules. They calculate it by taking your net profit and dividing it by minimum wage, so you just have to prove you're hitting the equivalent income/hours. Work requirements aren't new (SNAP and TANF have had them for years), the new bill just expands it to the Medicaid expansion group.
You will already have the paperwork you need in your schedule c from your quarterly filings and any documentation that you currently keep that logs your hours mileage expenses etc.
You will use the same documentation that others in the past have used while on government assistance and must prove their income.
For slim months it is important that you document the hours that you put in sourcing listing posting etc.
This is the proof you will need To show that you were meeting the 80 hour per month requirement. Start now.
coxreads
OP4 months agoThis is good information, thank you!
(Especially the part about free kittens!)
Dave
authentic*vintage
·4 months agoYou're welcome - the hardest part, as you know, is going to be showing that minimum wage profit after mileage, expenses, etc. - I do NOT recommend fudging any math that tips your numbers toward an imaginary profit to meet the requirements. Continue to keep accurate realistic records just as you would for filing taxes. In fact, they will be the same records.
My free cat costs me about $75/month
lacemaker3
·4 months ago@coxreads and @authentic*vintage,
Actually, this requirement is based on "monthly income" not on profits. So what an applicant would need to do is prove that their income for each month (payments received, not accounting for fees, CoGS, shipping costs, etc.) is above the equivalent of 80 hours work at minimum wage. They don't need to show profits that high.
That is fair because even minimum wage workers have deductions, so their take home pay is less than minimum wage. And some resellers may be selling their personal property to make ends meet, so they may not have any "profit" if they had to sell at a loss, but they may need the extra cash flow.
https://www.medicaid.gov/federal-policy-guidance/downloads/cib12082025.pdf
Section V, pages 4-5
authentic*vintage
·4 months agoThank you for clarifying this - I have a family member who is in this same situation - I will definitely pass this along!
lacemaker3
·4 months ago@authentic*vintage
This federal bill requiring community engagement for some medicaid recipients was only passed last July, 2025, and takes effect Jan 1, 2027. Some states may have had state-level requirements before, and they may choose to implement these requirements earlier, which would mean starting the community engagement requirement sometime this year, in 2026.
I don't know what the state-level requirements were before that (and I don't want to go down that rabbit hole right now), but I think you are way out ahead of the curve in being aware of this already. So, no regrets.
If you family member had to show profits that high to meet their state-level requirements before, then this may make it easier for them.
ETA: I'm still trying to avoid the rabbit hole, but after rereading this thread, it seems that a lot of people have not been able to use self-employment to meet their state-level guidelines before this. Or, they may have had to show profits above the minimum-wage-level, rather than income.
ETA2: Apparently only Georgia had state-level requirements like this as of mid-2025.
https://legalclarity.org/what-are-medicaid-work-and-community-engagement-requirements/
So for most, community engagement may be a new requirement but, the new requirements may not be as difficult as they appear at first sight.
authentic*vintage
·4 months agoI wish we had realized this before but it does make sense based on the way that SNAP income is calculated.
stuff4divas
·4 months ago@coxreads have you been filing your online selling income on your tax forms? if so, use that.
if not, you may open yourself up for medicaid fraud if you're trying to avoid reported income.
coxreads
OP4 months agoThanks! No, I am not trying to avoid anything. The new Federal work requirements involve working a set number of hours: 20 a week/80 a month. I have not seen anything yet about those of use who do not clock-in for work. Requiring work for Medicaid is new to most states-a couple of states have tried it and it didn't result in greater employment but it did result in people being kicked off, a lot of time for paperwork errors. So, I'll keep researching. Thanks!
go-bad-chicken
·4 months ago@coxreads My 2 cents, would be to schedule a consultation with a local attorney who specializes in settling up corporate entities and have them set up your enterprise up as an S Corp.
You create a board of directors for said entity, with a minimum of 3 board members (you and 2 other members), with you as its CEO. You issue stock.
98% of that stock is issued to yourself, and the remaining 2% is issued to the other 2 board members.
Then you begin paying yourself a bare minimum monthly living wage, as an employee (CEO) of said entity. For example, lets say $800 a month.
You then pay all taxes owed on that wage of $800, and wallah you are now an employee of an incorporated company.
Any profit that left over (hopefully the majority) after all company expenses, is then paid out as a stock dividend which is then taxed as capital gains, and is much, much lower than personal income taxes tax rate.
coxreads
OP4 months agoThanks for the info. Wow-that seems really complicated, but certainly a suggesting I'll save! Thanks!
tsme35
·4 months agoBest to check with medicare on the guide lines and how to report income. Also need to ask if they go by gross or net income, in my state they go by gross, so they don't deduct for inventory, shipping or taxes, just what your 1099 says. And you have to consider now your reporting your income, if you make too much, could knock you off the program.
coxreads
OP4 months agoThe problem is that this is all so new that there is little info on the web that I could find and the departments I've contacted aren't sure yet. But since this is a new federal requirement that will cover the entire country, this is one more avenue I was pursuing to see if anyone knew anything from their own experience.
Thanks! Dave
caldreamer
·4 months agoFederal government and State of Maine does not have clear definition of what is considered "work". Normally, selling on EBAY would be "self employment".
coxreads
OP4 months agoYes, that's what I'm thinking, and the 80 hours a month would be easier to show for someone who invoices for time worked or similar to show. This is all a feature, I guess. Leave us guessing and worrying!
Thanks!
mordecai8614
·4 months agoI imagine a detailed spreadsheet logging all your hours along with monthly sales statements might work. But honestly, with your very low volume of sales & low number of listings, it might be a hard sell to your case worker that you're really spending 20 hours a week on this.
coxreads
OP4 months agoYes, I see what you're saying, but I have a shop on another platform that takes most of my time. A LOT more sales and a lot more work.
mordecai8614
·4 months agoThat's good. I imagine Medicaid employees have a lot of experience with self-employed online retailers, I'd just reach you to them.
monroe67
·4 months agoI think you may be wasting a little too much advance anxiety.
Read, read, read everything about any applicable new regulations you can get your hands on. Including your virtual hands: read everything you can find on-line as well.
If there is anything you find particularly worrisome, contact your representative and/or senators. They may be able to support revisions that offer exemptions to people who sell stuff on eBay, as well as Etsy, Poshmark, OfferUp, Reverb (guitars), etc., etc., etc.
Then -- adapt. If volunteer hours "count" toward any work requirement, find a volunteer opportunity that interests you. Schools, hospitals, political organizations may have something for you to do.
coxreads
OP4 months agoThank you, Monroe. I had a stroke a few years ago and I am thankful it was covered. I do worry about loss of coverage because my work isn't the "right" kind of work. I do have many connections with the legislators and with organizations in my city. I'll start reaching out. 2027 will be here before I know it! Thank you for the advice!
stainlessenginecovers
·4 months agoThat is 'self-employment'.
Doesn't count.
Besides, selling/packing 4 items a month (12 sold in 3 months) would not qualify for 80 hours a month.
Need to go 'volunteer' at least 20 hrs a week (Soup kitchen, Salvation Army etc.)
coxreads
OP4 months agoWell, for some people who do sell 4 items a month, yeah, that would be a hobby. But for others who sell on multiple platforms, working 80 hours a month, sourcing, washing, photographing, listing, storing, packing, and taking to the post office, that is work. Thanks for checking the stats.
So, my question still stands. And what does "doesn't count" mean? Anyone who is self-employed will not need allow the work requirement guidelines?
stainlessenginecovers
·4 months agoSelf-Employment 'doesn't count' is what I think.
Not my rules and I don't see anything that supports SE when you 'report'.
Reporting and Verification
coxreads
OP4 months agoThis was published just three days ago! Thanks!
coxreads
OP4 months agoAt that site (https://legalclarity.org/what-are-medicaid-work-and-community-engagement-requirements/ ), I found this:
~~~~
The income alternative is the provision most people overlook. If you work two part-time gig jobs and your hours fluctuate week to week, proving exactly 80 hours can be a headache. But if your monthly earnings clear $580, you’ve met the threshold regardless of how your schedule looked. Self-employed individuals benefit from this approach especially, since documenting every hour of freelance work is impractical in a way that showing monthly revenue is not.
~~~~
So, that sort of answers my question. Now the next issue I'll try to figure out is what happens in July when sales are down to almost nothing-can the super great Mother's Day and Christmas months offset that? Sheesh! This really is worrisome.
Thank you everyone who's helped me with this!
go-bad-chicken
·4 months ago@coxreads once again consider what I shared in post #14.
As an employee of a company who receives a paycheck every 2 weeks for $400, no matter what, will not have a problem proving that they work the required 80 hours. You will have pay stubs, from a legal corporate entity that you can now submit to the state as evidence.
This is a very common, and once its set up its very easy to keep up with. And you'll save a boat load on taxes compared to other ebay sellers who pay income taxes on their total. And you'll satisfy all Social Security requirements to receive SS benefits later down the road.
lacemaker3
·4 months ago@coxreads, I was just going to post that, but I see that you have already found about it.
The next section answers your next question. You only have to provide proof when you first apply for Medicaid, and then again when you apply to renew it every 6 months beginning Jan 1, 2027 (currently, once a year).
https://legalclarity.org/what-are-medicaid-work-and-community-engagement-requirements/
ETA: to get more information about how many and which months you have to show compliance for, you have to go to the source for that information. On the page itself, click on the superscript 2 and follow the link.
That takes you to the original guidance document issued by medicaid.gov. Here, it says that each state has to determine how many months their residents will need to show compliance for, but if it is more than one month, they can't require them to be consecutive months (for renewals, specifically). So applicants will have some flexibility and should be able to not include at least some of their lower-income months. Starting next year, applicants will need to show compliance at least two months of the year, but it could be more in some states.
https://www.medicaid.gov/federal-policy-guidance/downloads/cib12082025.pdf Section VI, pages 7-8