Washington County could be hit hardest by Medicaid cuts going into effect in January, according to data The Maine Monitor received from the state under a public records request.

In 2025, Republican lawmakers in Congress passed the One Big Beautiful Bill Act, which requires some people who qualify for Medicaid — known as MaineCare in Maine — to work in order to receive health benefits. The people who will be required to work are those to whom the state expanded Medicaid coverage in 2019 under the Affordable Care Act because they earn up to 138 percent of the federal poverty level.  

All told, the measure is estimated to cut Medicaid spending nationally by $911 billion over a decade.

While health care providers have expected thousands of Maine people to lose Medicaid, they have not known exactly who will lose coverage or where they live. So The Monitor asked the Maine Department of Health and Human Services for the number of people in the Medicaid expansion group by county.

The numbers show publicly for the first time that 8.6 percent of the population in Washington County last year could be subject to new work requirements.

Aroostook and Somerset counties had the next highest rates with about 7 percent of the total population in the Medicaid expansion group. 

Piscataquis, Knox, Oxford, Androscoggin and Penobscot counties were next highest with each having between 6 and 6.5 percent of their populations in the Medicaid expansion group.

An additional 114 people were in the expansion group but were either not in the state or were not a Maine resident, or their county was unknown.

While these counties have the greatest percentage of people who qualified for Medicaid under the state’s expansion of coverage, it is unlikely that everyone in the group will be subject to Medicaid work requirements. That’s because there are some exemptions to the new law for certain people, such as those who are caregivers, or have substance use disorders or chronic conditions.

In total there were more than 78,000 people in the state’s expansion group last year who could be subject to work requirements, according to data from the state. That makes up about 5.5 percent of the state population. The state has previously estimated that 31,000 of those people would lose their coverage because they no longer qualify or because the additional paperwork will be too much of a barrier.

Those who must meet the new requirements will now have to show they are working, volunteering or attending school for 80 hours a month to keep their coverage. They will also have to meet reporting requirements every six months instead of once a year, and will have to do more to prove they are working or are too sick to work.

In addition, more than 600 immigrants in Maine, including refugees and asylum seekers who have not yet received a green card, likely will no longer be eligible for full benefits under MaineCare, according to the state. Children and pregnant people will be exempt from the work requirements.

The new requirements come at a time when health insurance tax credits have expired; the number of people enrolled in the state’s health insurance marketplace dropped by thousands from 2025 to 2026; and rates for private health insurance are set to increase 15 percent for individual plans next year.

This story was originally published by The Maine Monitor, a nonprofit civic news organization. To get regular coverage from The Monitor, sign up for a free Monitor newsletter here.