Latest
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New Federal Medicaid Work Reporting Rule Threatens Coverage for Vulnerable Americans
Statement by Joan Alker, Executive Director of the Georgetown University Center for Children and Families and Research Professor at the McCourt School of Public Policy: “This rule gives states a raw deal, but more importantly, puts health care at risk for people with illnesses and chronic conditions like cancer or a substance use disorder. It…
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Federal Work Reporting Requirements under H.R. 1
This page includes a summary of H.R. 1 and federal guidance on Medicaid work reporting requirements established under HR 1. The law requires CMS to publish an Interim Final Rule (IFR) no later than June 1, 2026. Resources will be updated as further federal guidance is released.
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State and Enrollee Materials
States will need to do outreach to communicate new requirements that apply to adults in Medicaid expansion. Without strong outreach, many families and individuals won’t know about the work requirements or how to comply, and may be incorrectly kicked off Medicaid coverage. HR 1 includes some outreach requirements for states, and it will be critical…
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State Administration and Technology Costs
States must upgrade their eligibility and enrollment systems, technology platforms, and administrative capacity to comply with HR 1’s work reporting requirements and more frequent renewals for Medicaid expansion adults. Implementing these new requirements is an enormous upfront and year-over-year cost to taxpayers, adding bureaucracy and red tape while taking away health coverage from low income…
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Medicaid Enrollment Trends
As many as 4.9 to 10.1 million people will lose Medicaid coverage by 2028 as a consequence of mandatory work reporting requirements and more frequent 6-month renewals based on a March 2026 study from the Urban Institute. This page includes a comprehensive 50-state Medicaid and CHIP enrollment tracker with the most recent data available on…