The Trump administration's federal work requirements exempt certain groups of people: those with disabilities, those older than 64, pregnant people and Native Americans, among others. Many conservative policymakers support work requirements, and some states have attempted to implement such rules for years. Many, like Pugh, qualified for Medicaid, though the number of enrollees who are homeless is difficult to measure. The work requirements are projected to increase the number of uninsured people nationwide by more than 5 million by 2034, according to the Congressional Budget Office. Most states will begin to implement the Medicaid work requirements in January 2027.