Medicaid work requirement

CMS Fleshes Out Medicaid Work Requirement

The Centers for Medicare & Medicaid Services has issued additional guidance to the states on how to implement the work and community engagements established as part of the criteria for Medicaid eligibility under H.R. 1, commonly known as the One Big Beautiful Bill Act, which was signed into law in July. The requirements seek to connect able-bodied, working-age adults with work and community engagement activities and reduce inappropriate Medicaid enrollment. The states are required to implement these requirements by January 1, 2027 but may do so sooner if they wish. In providing this guidance, CMS enumerates four major principles, quoted [...]

joe2025-12-10T12:57:33-05:00December 11, 2025|Centers for Medicare & Medicaid Services, Medicaid|

The Struggle to Help Prove Medicaid Eligibility

With new Medicaid work rules scheduled to take effect in 42 states by the end of 2026, policymakers are working to find new, better ways to enable Medicaid applicants to demonstrate that they are meeting Medicaid work and community engagement requirements. While the Centers for Medicare & Medicaid Services has set aside $200 million to pursue technology solutions for this problem, such efforts, at least so far, have not proven successful. In a test in Louisiana, for example, state officials sent text messages to 13,000 Medicaid enrollees, asking them to follow a link to a state web site at which [...]

joe2025-10-23T15:13:41-04:00October 28, 2025|Medicaid|

Medicaid Work Rule May Hit Chronically Ill

The introduction of a work requirement for Medicaid eligibility may have the greatest impact on Medicaid beneficiaries with chronic illnesses. According to a new analysis of the approximately five million people who are likely to lose their Medicaid eligibility between now and 2034 because of the new work requirement introduced in the FY 2026 budget reconciliation bill (the “One Big Beautiful Act Bill,”) more than 85 percent have at least one chronic medical condition and more than 40 percent have at least three such conditions. The percentages rise, moreover, among current Medicaid beneficiaries over the age of 50. Some of [...]

joe2025-10-07T13:44:24-04:00October 8, 2025|Medicaid|

New Medicaid Work Requirement Could Slam Hospital Finances

The Medicaid work/community engagement requirement included in the “One Big Beautiful Bill” Act could cost hospitals millions of dollars – losses that could translate into potential declines of 11.7-13.3 percent in hospital operating margins, according to a Commonwealth Fund analysis based on Urban Institute data. Not all current Medicaid participants are subject to the new work and community engagement requirements but between 5.5 million and 6.3 million people are expected to lose their Medicaid benefits as a result of those requirements. Among them, some will be newly unemployed; some will be unable to find work; and some will be employed [...]

joe2025-09-26T12:02:19-04:00October 1, 2025|hospitals, Medicaid|

The Coming Medicaid Work Requirement

Among the many Medicaid-related aspects of the recently enacted FY 2026 budget reconciliation bill – the One Big Beautiful Bill Act – is a new requirement that much of the Medicaid population be employed or participate in some acceptable form of “community engagement.” But how will the work requirement work? How will it be implemented and enforced? KFF has taken an in-depth look at this matter, reporting on such issues as: What the new law requires. The timeline for the work requirement’s implementation. How much money the states and the federal government stand to save by ending Medicaid How many [...]

joe2025-08-05T17:24:07-04:00August 6, 2025|Congress, Medicaid|

Five Million Could Lose Medicaid With Federal Work Requirement

If adopted, a federal requirement that Medicaid beneficiaries in expansion states work at least 80 hours a month to retain their eligibility for Medicaid could result in five million people losing their Medicaid coverage, according to a new analysis. And if that requirement were to be expanded to all Medicaid beneficiaries, that number could rise to as many as 30 million people. The analysis, included in a report released by the Robert Wood Johnson Foundation and the Urban Institute, concluded that: Between 4.6 and 5.2 million adults living in states that expanded Medicaid would lose Medicaid coverage next year under [...]

joe2025-03-26T09:46:47-04:00March 26, 2025|Medicaid|

Federal Health Policy Update for January 16

The following is the latest health policy news from the federal government for January 11-17. Some of the language used below is taken directly from government documents. Congress House Budget Committee Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending by between $5.3 trillion and $5.7 trillion over a period of ten years. Up to $3.4 trillion of those possible cuts could include reductions in federal health care spending. The health care cuts the document lists (all figures are ten-year reductions) are: Medicare introducing Medicare site-neutral outpatient payments - [...]

CMS: Not Done With Medicaid Work Requirements

Despite the ruling of a federal court that Kentucky’s new Medicaid work requirement violates federal law, the Centers for Medicare & Medicaid Services has not ruled out approving future requests from state governments to impose work requirements on Medicaid recipients. Or so asserted CMS administrator Seema Verma at a recent health care event in Washington, D.C. The Washington Examiner reports that at that event, Verma said that We are looking at what the court said. We want to be respectful of the court’s decision while trying to push ahead with our policy and our goals. CMS currently has applications from [...]

iqtsupport2018-07-18T09:24:15-04:00July 18, 2018|Medicaid|

CMS Rejects Bid to Impose Lifetime Limit on Medicaid Services

The Centers for Medicare & Medicaid Services has denied a request from the state of Kansas to impose a lifetime limit on the Medicaid benefits individuals may receive. In a move that the agency appeared to signal last week and that appears to have national implications, CMS administrator Seema Verma explained that We have determined that we will not approve Kansas’ recent request to place a lifetime limit on Medicaid benefits for some beneficiaries…We seek to create a pathway out of poverty, but we also understand that people’s circumstances change, and we must ensure that our programs are sustainable and [...]

iqtsupport2018-05-09T06:00:37-04:00May 9, 2018|Medicaid|

A New Wave of Medicaid Expansion?

Spurred by the Trump administration’s invitation to states to apply for approval to make work requirements a part of their Medicaid program, a number of states that spurned the opportunity created for expansion under the Affordable Care Act may consider pursuing Medicaid expansion in the near future. Currently, some elected officials in Idaho, Kansas, North Carolina, Utah, Virginia, and Wyoming appear to be considering what they once considered unthinkable: making more of their residents eligible for Medicaid. For the most part, expansion talk is coming from moderate Republican legislators who believe a work requirement may help soften the staunch opposition [...]

iqtsupport2018-02-01T06:00:45-05:00February 1, 2018|Affordable Care Act, Medicaid|