Several states have sought, and some received, the administration’s approval to require some Medicaid beneficiaries, including parents with children at home, to engage in and report on work or designated work-related activities to remain eligible for Medicaid. Some parents may need child care to comply with these Medicaid work requirements. This report explores what is known about the child care challenges they may face and suggests parents may struggle to find care that is affordable, good quality, accessible, and available for nontraditional or unpredictable work schedules. These realities suggest some parents will face difficult decisions: to leave children in suboptimal care (or alone) or fail to satisfy the requirements and lose Medicaid coverage. Both outcomes could compromise their children’s health and development in the near and long terms. Though the current legal scrutiny leaves the future of Medicaid work requirements uncertain, the child care challenges discussed in this report are also relevant for work requirement proposals that include parents in other safety net programs.