Tag: Medicaid
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Arkansas and Montana implement Medicaid work requirements before deadline
On July 1, Arkansas and Montana began implementing work requirements for Medicaid enrollees, becoming the second and third states to do so after President Donald Trump (R) signed the One Big Beautiful Bill Act (OBBBA) on July 4, 2025. The OBBBA established the first federal work requirements for Medicaid and requires states to adopt these…
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CMS releases interim final rule for Medicaid work requirements, defines medical frailty exemption
On June 1, 2026, the Centers for Medicare & Medicaid Services (CMS) released an Interim Final Rule with Comment Period (IFC) governing how states implement Medicaid work requirements — also known as community engagement requirements — enacted into law as part of the One Big Beautiful Bill Act (OBBBA). The nearly-400 page document establishes standards…
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Nebraska becomes first state to implement Medicaid work requirements after passage of the One Big Beautiful Bill Act
On May 1, Nebraska became the first state to implement Medicaid work requirements after Congress passed the One Big Beautiful Bill Act (OBBBA). The OBBBA directs states to adopt policies requiring able-bodied Medicaid recipients in the Affordable Care Act (ACA) expansion group to work 80 hours per month beginning January 1, 2027. Nebraska became the…
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Kentucky legislature overrides governor's veto on Medicaid work requirements bill
On April 14, 2026, the Kentucky General Assembly voted along party lines to override line item vetoes from Kentucky Gov. Andy Beshear (D) of House Bill 2 and enshrined changes to Medicaid rules into state law. Beshear had vetoed several portions of the bill, including a requirement that Medicaid applicants demonstrate three months of compliance…
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Idaho governor signs Medicaid work requirements bill requiring three months of compliance before enrollment
A previous version of this story included an error stating that Idaho was the only state requiring three months of compliance with Medicaid work requirements prior to enrollment. Indiana also recently passed a bill that requires this. On April 10, 2026, Idaho Gov. Brad Little (R) signed House Bill 913 establishing Medicaid work requirements in…
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Mandatory Medicaid work requirements are coming, what do they look like now?
The 2025 budget reconciliation bill, the One Big Beautiful Bill Act (OBBBA), established mandatory work requirements for certain able-bodied Medicaid recipients beginning in 2027. By creating a federal mandate, the OBBBA significantly changed the national landscape of Medicaid work requirements and states must respond by designing and implementing systems to comply, or risk losing federal…
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House Energy and Commerce Committee includes Medicaid work requirement in budget reconciliation bill
The House Energy and Commerce Committee passed its budget reconciliation bill on May 14 with a 30-24 vote after a May 13th markup of the previous draft version. The current version of the bill would require states to adopt community engagement requirements for able-bodied adults without dependents on Medicaid. The current version specifies community engagement…
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Kentucky Legislature overrides veto on Medicaid work requirements bill
On March 27th, the Kentucky Legislature voted to override Gov. Beshear's (D) veto of House Bill 695, which requires the state to seek work requirements for able-bodied adult Medicaid recipients. Kentucky has a divided government with a Republican-controlled legislature and a Democratic governor. Kentucky is one of six states that require a simple majority vote…
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South Dakota voters to decide on constitutional amendment to condition Medicaid expansion on continued federal funding in Nov. 2026
In South Dakota, voters will decide on a constitutional amendment to condition state Medicaid expansion on federal funding remaining at or above 90%. Voters will decide on the amendment in the election on Nov. 3, 2026. If federal funding falls below 90%, the constitutional requirement for Medicaid expansion would no longer apply. Voters adopted this…
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Summary of the Trump administration's history on Medicaid work requirements
Donald Trump (R) was inaugurated as president for his second term on January 20, 2025. During his first term, the Centers for Medicare and Medicaid Services (CMS) invited states to apply for Section 1115 waivers, which, if approved by CMS, allow states to implement work requirements and other conditions for Medicaid. Between 2018 and 2020,…