- Work for It. What Trump's Tough New Medicaid Rules Mean NBC News by Benjy Sarlin — Under the new system, called Kentucky HEALTH, nonelderly adult Medicaid recipients will have to hold a job or perform 80 hours a month of "community engagement" activity like classes and volunteering, pay a monthly premium of $1 to $15, earn their vision and dental treatment through a rewards program, and go through the enrollment process again every year. Those who fail to meet the requirements could lose their coverage or face additional copays. Interviews with health professionals, administrators, patients and advocates preparing for the change reveal deep concerns. The new rules, they warn, will jeopardize health care for numerous vulnerable residents. The state has added over 450,000 residents to Medicaid through Obamacare, which provided funding for adults making up to 138 percent of the poverty line, and the new work requirements primarily affect this group. The Medicaid changes are becoming a national flashpoint as the political parties diverge on health care, with Democrats increasingly treating government-backed health care as a fundamental right for all Americans and Republicans arguing it should be earned through work or limited to the most vulnerable citizens.