Missouri will not use optional federal exemptions designed to help low-income people keep Medicaid coverage when they are hospitalized, travel for medical care or live in areas affected by disasters or high unemployment.The exceptions are optional in the One Big Beautiful Bill Act, which starting Jan. 1, 2027 will require states to verify that adults ages 19 to 64 covered through Medicaid expansion work, attend school or volunteer 80 hours a month to get or maintain coverage.