How H.R. 1 Cuts and Changes to Medicaid Played out in 2026 State Legislative Sessions (Part 2)

It’s been nearly a year since H.R.1 was signed into law, enacting the largest Medicaid cuts in history and setting off a scramble in state capitals to respond. Back in March, we took a look at how ten state legislatures were grappling with the impending budget holes and policies created by H.R.1. Now that most…

July 2, 2026

By

Jade Little

and

Adriana Kohler

Presentations

Webinar: Medicaid Financing

The Georgetown University Center for Children and Families hosted a webinar took place on Tuesday, June 30 at 2pm ET. This webinar covered the basics of Medicaid financing, including how the federal-state partnership works, how federal funding is mandatory and not subject to annual appropriations, and how states finance their share of Medicaid costs. It…

June 30, 2026

Blog

Trump Administration Issues Section 1115 Medicaid Waiver Financing Guidance Which Goes Far Further Than H.R. 1 (Again)

On Friday, June 11 the Centers for Medicare and Medicaid Services (CMS) issued new guidance on the Secretary’s approach to implementing Section 1115(g) which was added to the Social Security Act by H.R. 1 – the President’s signature budget bill enacted last year. (Our explainer of the health provisions in the bill can be found…

June 25, 2026

By

Joan Alker

and

Edwin Park

Blog

Would Benjamin Franklin’s Volunteer Fire Brigade Satisfy DHHS’s Proposed Rule on Medicaid Work Reporting “Community Engagement” Requirements?

Americans, as French political scientist Alexis de Tocqueville observed in 1831, have a special propensity for coming together outside of government as volunteers for community improvement. From Benjamin Franklin’s organization of the nation’s first volunteer fire brigade to President George H. W. Bush’s 1989 call for Americans to volunteer as a “thousand points of light,”…

June 18, 2026

By

Adam Searing

Blog

The New Medicaid Work Reporting Requirements Are Here—Don’t Let the Nebraska “Soft Start” Fool You

On May 1, 2026, Nebraska became the first state to start the new work requirements under H.R. 1, the law passed last year making historic cuts to Medicaid. We have reported extensively on why work reporting requirements are a bad idea. Nebraska was not adequately prepared to launch work reporting requirements, nor has the Centers…

May 11, 2026

By

Leonardo Cuello

Blog

Drop in Child Medicaid and CHIP Enrollment Even Before HR 1 Policies Take Full Effect is Troubling Sign

The drop in Medicaid/CHIP enrollment means more children are likely becoming uninsured. We spend a lot of our time at the Georgetown University Center for Children and Families monitoring child and adult Medicaid and the Children’s Health Insurance Program (CHIP) health coverage trends. The latest federal CMS data confirms that child enrollment in these programs…

May 8, 2026

By

Joan Alker

Blog

What Do We Know So Far About State Materials & Consumer Outreach on Medicaid Work Reporting Requirements?

States need to do effective, consumer-friendly outreach and education to communicate new work reporting requirements to affected Medicaid expansion adults and new applicants. Mandatory work reporting is one of the biggest seismic shifts in Medicaid policy in a generation, and without strong outreach and public awareness – including through content that is easy to understand…

May 7, 2026

By

Adriana Kohler

and

Jade Little

Blog

2026 Report on State Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies Includes Special Edition on Medicaid Work Requirements

Yesterday, the annual KFF survey report was released with a webinar featuring highlights of two reports and a discussion that included Kate McEvoy, executive director of the National Association of Medicaid Directors, and was moderated by KFF’s Larry Levitt. The webinar and reports contain important information that should be of interest to policymakers, stakeholders, members…

May 1, 2026

By

Tricia Brooks

State Page

Tracking West Virginia Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. West Virginia is one of 16 states where only CMS data…

April 11, 2026

State Page

Tracking Washington Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Washington posts monthly state administrative data, including Medicaid enrollment. Timely administrative…

April 11, 2026

State Page

Tracking Virginia Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Virginia posts monthly state administrative data, including Medicaid enrollment. Timely administrative…

April 11, 2026

State Page

Tracking Vermont Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Vermont is one of 16 states where only CMS data –…

April 11, 2026

State Page

Tracking Utah Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Utah posts monthly state administrative data, including Medicaid enrollment. Timely administrative…

April 11, 2026

State Page

Tracking South Dakota Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. South Dakota posts monthly state administrative data, including Medicaid enrollment. Timely…

April 11, 2026

State Page

Tracking Rhode Island Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Rhode Island is one of 16 states where only CMS data…

April 11, 2026

State Page

Tracking Pennsylvania Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Pennsylvania is one of 16 states where only CMS data –…

April 11, 2026

State Page

Tracking Oregon Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Oregon is one of 16 states where only CMS data –…

April 11, 2026

State Page

Tracking Oklahoma Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Oklahoma posts monthly state administrative data, including Medicaid enrollment. Timely administrative…

April 11, 2026

State Page

Tracking Ohio Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. Ohio posts monthly state administrative data, including Medicaid enrollment. Timely administrative…

April 11, 2026

State Page

Tracking North Dakota Implementation of H.R. 1 Medicaid Work Reporting Requirements

Medicaid Enrollment Trends The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program. North Dakota posts monthly state administrative data, including Medicaid enrollment. Timely…

April 11, 2026

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