Rhode Island expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 71,519 of them (10.7% of an expansion pool of 76,455) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.
This model's bottom-up estimate is that 19,422 people in Rhode Island lose coverage by 2034: 17,277 of them still eligible but lost to paperwork and reporting failures, and 2,146 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.
Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Rhode Island scores 77 of 100 on this model's ex parte capability index, a low band; its eligibility system is RIBridges.
Key figures
| Measure | Rhode Island |
|---|---|
| Expansion state | Yes |
| Subject to the requirement via waiver | No |
| Expansion pool (adults 19 to 64) | 76,455 |
| Adults subject, strict definition | 71,519 |
| Adults subject, permissive definition | 70,089 |
| Share of expansion pool subject | 10.7% |
| Projected coverage loss by 2034 | 19,422 |
| Hardship exception status | No qualifying counties |
| Early implementer | No |
| Ex parte capability score (0 to 100) | 77 (low) |
Who is subject in Rhode Island
Of the 71,519 subject adults, 26% already work 80 or more hours a month and 64% are not working. 17% have a child under 14 at home. Among those not working, 55% report a disability and 7% are caregivers.
| Characteristic | Share of subject adults |
|---|---|
| Age 19-24 | 16% |
| Age 25-34 | 18% |
| Age 35-44 | 14% |
| Age 45-54 | 21% |
| Age 55-64 | 31% |
| Not working | 64% |
| 1 to 19 hours a month | 1% |
| 20 to 79 hours a month | 9% |
| 80 or more hours a month (meets the bar) | 26% |
| Not working: Disabled | 55% |
| Not working: Caregiver | 7% |
| Not working: Postpartum | 0% |
| Not working: Student | 3% |
| Not working: Other | 35% |
Why eligible people lose coverage
Of the 19,422 projected to lose coverage in Rhode Island, 17,277 meet the requirement or qualify for an exemption but fail to document it. 6,315 of those are working people who cannot prove their hours through data the state can see, and 10,961 qualify for an exemption the state does not detect automatically.
| Group | Projected to lose coverage |
|---|---|
| Multiple part-time jobs (aggregation failure) | 2,253 |
| Self-employed (other) | 1,158 |
| Variable shifts / on-call work | 901 |
| Full-time students not auto-verified | 563 |
| Volunteering / job training | 435 |
| Cash-paid construction & trades | 387 |
| Gig / courier (DoorDash, Uber, Lyft, Instacart) | 312 |
| Seasonal: agriculture, hospitality, food service | 306 |
| Medically frail without auto-match | 5,629 |
| Caregivers of a disabled adult | 2,989 |
| American Indian / Alaska Native (tribal exemption) | 728 |
| SUD treatment not flagged in claims data | 634 |
| Kinship caregivers (non-parent) of children ≤13 | 337 |
| Other categorical exemptions (foster, AYA cancer, SNAP/TANF) | 222 |
| Parent caregivers of children ≤13 without auto-match | 210 |
| Recent incarceration (data-match gap) | 193 |
| Pregnancy / postpartum data lag | 20 |
Can the state renew people automatically?
The ex parte capability index blends the state's observed automatic-renewal rate (92% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Rhode Island's composite score is 77 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.
| Component | Score |
|---|---|
| Composite | 77 |
| Observed ex parte | 92 |
| Core capability | 66 |
| Data sources | 68 |
| Historical churn | 50 |
How subjects overlap across exemption categories
| Combination | Adults | Share |
|---|---|---|
| None of the four | 31,906 | 44.6% |
| Medically frail | 15,909 | 22.2% |
| Working ≥ qualifying hours / income | 12,020 | 16.8% |
| Full-time student | 3,625 | 5.1% |
| Working ≥ qualifying hours / income + Full-time student | 3,110 | 4.3% |
| Working ≥ qualifying hours / income + Parent caregiver of child ≤13 | 2,658 | 3.7% |
| Parent caregiver of child ≤13 | 1,236 | 1.7% |
| Working ≥ qualifying hours / income + Medically frail | 339 | 0.5% |
Counties in Rhode Island
Subject adults concentrate: Providence County (40,870), Kent County (10,843), and Washington County (10,181) account for 87% of the state's subject population.
| County | Adults subject | Subject rate | Projected loss | Poverty rate | Working-age population |
|---|---|---|---|---|---|
| Providence County | 40,870 | 9.9% | 11,099 | 14.0% | 411,890 |
| Kent County | 10,843 | 10.4% | 2,945 | 8.0% | 103,880 |
| Washington County | 10,181 | 13.3% | 2,765 | 8.0% | 76,722 |
| Newport County | 6,002 | 12.4% | 1,630 | 8.0% | 48,351 |
| Bristol County | 3,623 | 12.2% | 984 | 7.0% | 29,788 |
State brief and methodology
Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.