Enrollment & timing
KFF: 120,000 People Waiting for Medicare Disability Coverage Used Medicaid as a Bridge. Work Requirements Starting January 2027 Could End That.
A new KFF analysis finds that more than 120,000 people who transition to Medicare through disability benefits each year had relied on Medicaid expansion while waiting out Medicare's two-year waiting period. A 2025 federal law applies work requirements to Medicaid expansion starting January 2027.
By the Goodsurance editorial teamOctober 16, 2026
People who qualify for Medicare through Social Security Disability Insurance must typically wait 24 months before their Medicare coverage begins. A KFF analysis published October 14, 2026, finds that Medicaid expansion has become a critical bridge for many during that gap, and that a 2025 federal law now places that bridge at risk.
In 2023, more than 120,300 SSDI beneficiaries who were newly enrolling in Medicare had used Medicaid expansion coverage while waiting for Medicare to start. That figure represents more than one in four of the roughly 415,300 people who transitioned from SSDI status to Medicare enrollment that year. Looking at all Medicaid pathways together, 58 percent of newly enrolled Medicare disability beneficiaries, about 240,300 people, had some form of prior Medicaid coverage.
120,000+ people each year rely on Medicaid while waiting two years for Medicare disability coverage. A 2025 law puts that bridge at risk starting January 2027.
The 2025 reconciliation law requires most Medicaid expansion enrollees to document at least 80 hours of work or qualifying community activity per month to remain eligible, beginning January 2027. KFF notes that SSDI applicants face a structural tension: to qualify for SSDI at all, a person must already be found unable to perform substantial gainful activity. Meeting work documentation requirements while demonstrating disability for SSDI purposes may be difficult in practice.
The backlog adds urgency. As of July 2026, 885,000 people were awaiting initial disability determinations from Social Security, with initial decisions taking an average of 186 days. People in that queue are, by definition, in the waiting period during which Medicaid serves as their primary coverage. The 2025 law includes a medical frailty exemption, but KFF notes that documentation requirements could present additional barriers for the most seriously ill applicants.
In plain words
If you become disabled and qualify for Social Security Disability Insurance, you usually wait two years before Medicare starts. During that wait, many people use Medicaid to stay covered.
A study from KFF found that in 2023, about 120,000 people who were waiting for Medicare had been using Medicaid expansion for their health coverage. That is more than one in four people in that situation.
Starting in January 2027, a new federal law will require most Medicaid expansion members to show they work or do community activities for at least 80 hours a month. The problem is that people who qualify for SSDI already had to prove they could not work. Meeting work rules while also proving disability is a conflict that could be hard to resolve on paper.
As of July 2026, about 885,000 people were still waiting on a disability decision from Social Security. Those decisions were taking about 186 days on average. For all those people, losing Medicaid before Medicare starts could mean a gap with no health coverage at all.
The law does have an exception for people who are very sick, but that exception requires extra paperwork that can be hard to complete when you are seriously ill.
Understand the basics first
Source: KFF
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