密苏里州和爱荷华州等州选择不采用旨在帮助低收入人群在困难时期保持医保覆盖的豁免措施。
一些拒绝接受新医疗补助要求困难豁免的保守州可能出于政治原因而选择不参与，专家表示。
States like Missouri and Iowa are choosing to not take up exemption designed to help low-income people keep coverage during hardship Some conservative states that have rejected hardship exemptions for the new Medicaid requirements may be choosing not to due to political reasons, experts say.
联邦针对医疗补助的新工作要求将于2025年1月1日生效，届时通过《平价医疗法案》（ACA）医疗补助扩张参保的成年人每月需至少工作、上学、志愿服务或参与其他符合条件的活动80小时，以维持其医保覆盖。
New federal work requirements for Medicaid, slated to come into effect on 1 January, mean that adults enrolled through the Affordable Care Act (ACA) Medicaid expansion will have to work, attend school, volunteer, or take part in another qualifying activity at least 80 hours a month to maintain their coverage.