Rep. Pat Harrigan (R-NC) has introduced a bill aimed at preventing people from using gambling winnings to satisfy new Medicaid work requirements set to take effect in 2027.
The bill, called the “No Gambling for Medicaid Act,” would amend federal law to exclude certain gambling winnings from counting as monthly income under Medicaid’s community engagement requirement, according to a one-pager released alongside the legislation.
Starting January 1, 2027, under the One Big Beautiful Act (OBBA), certain non-disabled adults ages 19 to 64 who are covered by Medicaid will have to meet an 80-hour-a-month work requirement to keep their coverage. One way recipients can satisfy that requirement is by showing household income of at least $580 a month — a figure derived from multiplying the federal minimum wage of $7.25 by 80 hours.
The Centers for Medicare and Medicaid Services issued an interim final rule in June implementing the new work requirement for eligible Medicaid recipients.
How the loophole works
According to Harrigan’s office, gross gambling winnings count as income for Medicaid purposes just as they do for tax filing — meaning a recipient could meet the $580 threshold without actually coming out ahead financially.
The one-pager lays out an example: a person could bet on both sides of the same event at two different sportsbooks, guaranteeing one winning bet and one losing bet, and still rack up $580 in gross winnings while risking little in net losses.
Because most states, according to a March survey cited in reporting on the issue, only require recipients to show one qualifying month out of every six-month recertification period, a single month of strategically placed bets could be enough to satisfy the requirement for half a year.
“A recipient can reach $580 in gross winnings without risking significant net losses, for example by betting on both sides of a single event at two different sportsbooks,” the one-pager states. “A law meant to encourage work and community engagement could thus encourage more frequent and targeted gambling instead.”
Harrigan’s reaction
Harrigan flagged the issue publicly in an October 21 post on X, sharing a Washington Post opinion piece by Kevin Corinth, a senior fellow at the American Enterprise Institute.
“If Washington thinks placing bets counts as holding a job, Washington has lost its mind,” Harrigan wrote. “A loophole in Medicaid’s new work requirements could let someone qualify by gambling just $580 a month, and I’m introducing legislation to shut it down.”
In his Washington Post piece, Corinth argued the new work requirement is actually fairly flexible, noting that pregnant women, parents of children under 14, caretakers of people with disabilities and other groups are exempt. He also pointed out that recipients can satisfy the requirement through work, training, volunteering, school enrollment, or by showing the $580 monthly income threshold — and that as currently written, gambling winnings count toward that threshold even when bets are placed in a way that produces no real net gain.
What the bill would do
Harrigan’s legislation would define “covered gambling winnings” as any prize, award, or money derived from a bet or wager, and would exclude that income from counting toward the Medicaid work requirement. The bill includes a carve-out for professional gamblers, exempting wagering that is conducted as part of a trade or business.
