Tennessee Medicaid work requirement
Tennessee did not adopt the ACA Medicaid expansion, so most TennCare adults are outside the federal 80-hour rule. But CMS's June 2026 list identifies Tennessee's 1115 waiver as covering some enrollees who are subject. If you are covered through a TennCare waiver program, verify whether the requirement applies to you; adults on ordinary disability, pregnancy, or parent/caretaker coverage are not subject.
What this means for you
Nothing is required of you today under the federal rule. Watch for state-level proposals (Georgia shows a non-expansion state can build its own), and keep your contact info current with TennCare so any change reaches you.
The rule in one paragraph
Adults 19-64 covered through the ACA expansion group must show 80 hours a month of work, community service, or work programs — or half-time school enrollment, or at least $580/month in income — unless exempt. Compliance is checked at application and at renewals (at least every 6 months). Miss it and the state must give 30 days notice before coverage ends.
The 10 federal exemptions
- Under 19 or over 64
- Pregnant or postpartum
- Parent or caretaker of a child 13 or younger, or of a disabled person
- Medically frail or with special medical needs
- Veteran with a total disability rating
- American Indian / Alaska Native
- Already meeting SNAP or TANF work rules
- Recently released from incarceration
- In a drug or alcohol treatment program
- Short-term hardship
Do my hours count?
- Paid employment Counts
- Self-employment / gig work Counts
- Volunteering Counts
- School / training Half-time+
- Caregiving Exempts you instead
- Job searching Not federally
Full detail, including the $580/month income route and the seasonal-worker rule: what counts toward the 80 hours.
Verify with TennCare (your state Medicaid agency) before making coverage decisions. States control reporting systems, exact dates, and hardship processes. Data snapshot 2026-07-03.
Sources
Get your state's deadlines by email
One short email when your state's work-requirement rules or dates change, plus new plain-English guides when we publish them. Free, no spam.