From KFF Health News –
The 2025 reconciliation law, once called the “One Big Beautiful Bill,” signed by President Trump on July 4, 2025, conditions Medicaid eligibility for adults in the Affordable Care Act (ACA) Medicaid expansion group and enrollees in partial expansion waiver programs (Georgia and Wisconsin) on meeting work requirements starting January 1, 2027. Currently, 41 states (including DC) have expanded their Medicaid programs under the ACA to nearly all adults with income up to 138% FPL ($21,597 for an individual in 2025).
To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements, including:
- NEW: State reported plans and policies related to implementing Medicaid work requirements and county-level unemployment rate data, as well as state and national data on Medicaid enrollment, renewal outcomes, and application processing times;
- Federal guidance and a list of policy and operational questions that states will need to answer as they implement work requirements;
- Updates on states implementing work requirements early through state plan amendments or 1115 waivers; and
- A compilation of KFF issue briefs and other resources on Medicaid work requirements.
This resource will be updated to include guidance from the Centers for Medicare and Medicaid Services (CMS), information on state policy decisions as they are made, and new data when available.
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