New federal Medicaid work requirements, mandated by the One Big Beautiful Bill Act signed into law last summer, are poised to significantly strain already understaffed state agencies, potentially hindering access to essential health coverage for millions. These rules, set to take effect in most states by January 1, 2027, will require state workers to verify enrollees' eligibility more frequently (every six months instead of annually) and determine compliance with new work mandates. Many states are already struggling with processing applications and fielding calls, with some reporting significant delays and high call wait times. The Congressional Budget Office estimates these changes could lead to over 5 million people losing coverage by 2034, exacerbating existing challenges in customer service and benefit access for low-income individuals and those with disabilities.