Indigenous Groups Are Exempt From Medicaid Work Rules, but Native Hawaiians Aren’t

Native Hawaiians will have to comply with the new work requirements in President Donald Trump’s signature One Big Beautiful Bill Act, despite facing significant obstacles to employment and healthcare.

By: Ashley Mizuo

Outlets: KFF Health News

Published: September 11, 2026

Words: 1,243

Last Updated: 1 week ago

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WAIANAE, Hawai‘i — Native Hawaiians will need to comply with new work requirements to qualify for Medicaid after being excluded from exemptions carved out for other Indigenous groups, an omission that clinicians fear will exacerbate the challenges the marginalized population already faces in getting healthcare.

In 43 states and the District of Columbia, President Donald Trump’s signature One Big Beautiful Bill Act will require most adults to work, go to school or enter a …

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