The Maine Department of Health and Human Services is gearing up for the rollout of the new Medicaid work requirements that are set to launch in 2027.

The department plans to spend $8 million to upgrade its online registration system and hire 35 workers to administer the new tasks of checking whether enrollees are eligible for the government health insurance, said Ian Yaffe, director of the Maine Office for Family Independence, which is overseeing the changes.

The new work requirements — which mandate that some Medicaid recipients work 80 hours per month, attend school or volunteer — were part of the federal budget bill that passed last year. The bill delayed the bulk of the Medicaid cutbacks until 2027.

The work requirements would apply to about 90,000 adults in Maine, according to DHHS. The new requirements impact those who qualified for Medicaid after Maine expanded the program in 2019. Groups exempted from the work requirements include adults with disabilities, all children, and those age 65 and older.

The state has estimated over 31,000 people in Maine will lose coverage as a result of the changes.

Yaffe said the aim is to maintain access for those who remain eligible for Medicaid, as enrollees navigate the changes to the program.

DHHS plans to hire 35 employees this summer whose jobs will include checking that enrollees are complying with the work requirements, which start in January. Yaffe said the department has not begun advertising for the job openings. The administrative cost of implementing the work requirements in Maine is expected to be $8 million in the first year, and $5.5 million per year thereafter, according to state estimates.

The state will also be required to check enrollment status for Medicaid recipients every six months, instead of once per year.

Yaffe said DHHS wants to minimize the number of Maine residents who are eligible for Medicaid from becoming uninsured because paperwork was filled out incorrectly. If an employer can verify a Medicaid enrollee’s income, for instance, Maine will maintain that enrollee’s eligibility rather than require the Medicaid recipient fill out extra paperwork, he said.

“Our goal is to make it as seamless and as accurate as possible, so that eligible people maintain their enrollment without an additional administrative burden,” Yaffe said.

Nationally, the Congressional Budget Office projects 4.8 million people will lose Medicaid coverage by 2034 and become uninsured. The new law prohibits those who lose Medicaid coverage because they failed to meet the new requirements from purchasing subsidized Affordable Care Act plans.

The upcoming Medicaid changes come on the heels of tighter restrictions to the Supplemental Nutrition Assistance Program, which went into effect last year.

“Ultimately, the human cost will be people losing health care coverage and food assistance, dealing major hits to household budgets in quick succession,” said Joseph Llobrera, senior director of research for the food assistance team at the Center on Budget and Policy Priorities, a left-leaning national think tank.

The Trump administration has said the new rules will spur more people into the workforce. A KFF analysis of Arkansas, which implemented its own work requirements for Medicaid in 2018, shows that the requirements resulted in more people being uninsured without increasing employment, said Amaya Diana, a policy analyst for KFF, a national health policy think tank.

Diana said even for states doing their best to preserve access to Medicaid, some recipients will lose their insurance for procedural reasons, not because they no longer qualify.

“It’s going to be complicated for the states to explain all the new documentation requirements,” Diana said. “It’s a big lift for states.”