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What medical conditions qualify for an ABAWD exemption under SNAP?
Executive summary
Federal SNAP rules reinstituted national ABAWD work limits effective November 1, 2025; able-bodied adults ages 18–64 without dependents must work or participate 80 hours/month to keep benefits beyond three months unless they meet an exemption (for example, pregnancy, medical unfitness, homelessness, veteran or caregiver status are listed as exemptions in multiple guides) [1] [2]. State agencies are required to screen for and apply exemption criteria and may also use limited discretionary exemptions allocated by USDA [3] [4].
1. What “medical” or health-related exemptions look like — plain language
State and federal guidance treat “medically unfit” or health-related exemptions as situations where a physical or mental health condition prevents someone from meeting the ABAWD work/training threshold; states provide medical-exemption forms that clinicians can complete to document incapacity, pregnancy, or participation in substance-use treatment [5] [6]. Federal FNS implementation material directs states to screen for exemptions at application or recertification and to accept medical documentation when a participant indicates they are unable to comply with ABAWD requirements [3].
2. Typical categories repeatedly named in reporting
Multiple public-facing summaries list the same health-related categories as exemptions: pregnancy, medically unfit (disability or health condition), homelessness, veterans, and caregivers; these are presented in the same short lists by several organizations summarizing the November 2025 enforcement [1] [2]. These summaries are consistent about pregnancy and “medically unfit” as explicit medical or health-based reasons to be exempt [1].
3. How states implement and verify medical exemptions
States must screen for and document exemptions and generally require a medical exemption form or comparable evidence; New York’s SNAP guidance and local health advisories advise patients and providers to return completed ABAWD Medical Statement or Exemption Forms to county/state offices before benefit actions happen [5] [6]. The federal FNS memo on OBBB implementation tells states to immediately apply modified exception criteria and to integrate screening into normal application/recertification procedures [3].
4. Limits, discretionary exemptions and state variation
Even when an individual qualifies for a medical exemption, states also received a limited number of discretionary exemptions for populations they want to cover administratively; FNS allocates those discretionary exemptions by formula and maintains reporting rules — and a state’s available discretionary exemptions can vary or be exhausted [4]. Additionally, some states had previously used area waivers or temporary federal waivers; those local policies affect how many people are subject to work rules in practice and whether exemptions are needed [7] [5].
5. What the sources do not say (important gaps)
Available sources do not list an exhaustive, standardized checklist of specific diagnoses that automatically qualify someone for a medical exemption; they describe “medically unfit” broadly and rely on state procedures and clinician documentation [3] [5]. Available sources do not provide a single national form or an explicit list of required medical evidence for every state — instead, they indicate states will set and verify criteria locally [3] [6].
6. Practical steps for patients, clinicians and caseworkers
State guidance and local health advisories urge early action: if a recipient believes they are unable to meet work hours due to health, submit a Medical Exemption Form or similar documentation to your county/state SNAP office as soon as possible; clinicians should complete the forms promptly to avoid benefit loss [5] [6]. States will notify affected participants in writing before reducing benefits, but providers and clients are advised to act ahead of deadlines [1].
7. Competing perspectives and the political context
Advocates and some state materials highlight the risk that reinstated enforcement could cut benefits for hundreds of thousands and emphasize broad exemptions for pregnancy and medical incapacity [1] [2]. At the same time, FNS and proponents of stricter work rules argue the changes restore long-standing statutory ABAWD limits and give states tools (discretionary exemptions) to tailor relief [3] [4]. These competing frames — emphasizing hunger risk vs. rule re‑establishment and state discretion — appear across federal memos and public analyses [3] [1].
If you want, I can: (A) pull the specific medical-exemption form language for a particular state (if you tell me which state), or (B) draft a clinician-ready template statement that mirrors typical state medical-exemption forms cited above for quicker submission [5] [6].