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Rural Hospitals and Communities Feeling Impact of H.R. 1 Medicaid Cuts, Rural Health Fund Falls Short
More stories have been published across the country in recent weeks detailing how the federal cuts to health care passed last year by Congress and signed into law by President Trump in H.R. 1, “The One Big Beautiful Bill”, are affecting communities. One emerging theme is that the Rural Health Transformation Fund – a $50…
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Governors and State Medicaid Directors Get a New Assignment from Dr. Oz: Quickly Recertify “High-Risk” Providers
On April 23, CMS Administrator Dr. Mehmet Oz sent a letter to all 50 Governors calling upon their Medicaid programs to “undertake a swift revalidation of Medicaid providers of services at high risk of waste, fraud, abuse, and corruption.” In the letter he requests that the Governor notify CMS within 10 business days (May 7)…
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Congress Wanted to Protect People Living in Areas with High Unemployment from Losing Health Care Due to Work Reporting Requirements. Will it Actually Happen?
During the Congressional debate about the passage of H.R. 1, many concerns were raised about the adoption of a mandatory work reporting requirement for people covered by Medicaid expansion – including the risks of people living in areas with high unemployment losing health coverage despite their best efforts to find work. In response, statutory language…
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Louisiana Loses a Formidable Child Health and Medicaid Champion in Ruth Kennedy
A few weeks ago, I learned that our friend, Ruth Kennedy, former LaCHIP and Medicaid Director in Louisiana, had passed away. I met Ruth back in the early 2000’s when we were both CHIP directors and participated in the Covering Kids and Covering Kids and Families grant programs funded by the Robert Wood Johnson Foundation.…
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States Work to Prevent Fraud Against Medicaid, Administration Uses Fraud to Attack Program
The first three months of 2026 have witnessed an unprecedented series of fiscal and rhetorical attacks on states by the White House and the political leadership at CMS, ostensibly about fraud against Medicaid. The focal point of these attacks has been Minnesota. On January 6, CMS notified the Governor of Minnesota that his state was out…
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New ACIP Charter Signals Possible Change in Priorities for Committee
The Centers for Disease Control and Prevention (CDC) has renewed the charter for its Advisory Committee on Immunization Practices (ACIP), retroactively effective to April 1, 2026. This two-year renewal is not unexpected, as HHS provided a notice of charter renewal in the Federal Register earlier this month, but several changes to the charter language provide…
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States Rely on Adequate Funds from Title V MCH Block Grant to Address Maternal and Child Health Needs
The Title V Maternal and Child Health (MCH) Block Grant is a federal-state partnership focused on improving the health of women, children, and families. Originally enacted in 1935, Title V of the Social Security Act authorizes federal funding for programs and projects to improve the health of mothers and children across the country. Since 1981,…
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Rooted in Justice and Joy: What Black Maternal Health Demands of Us Right Now
This week marks the 10th annual Black Maternal Health Week led by the Black Mamas Matter Alliance (BMMA). The theme, Rooted in Justice and Joy, honors a decade of movement-building by Black-led organizations while also naming the systemic forces –systemic oppression, reproductive injustices, and health inequities— that continue to threaten the lives of Black Mamas.…
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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…
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State Implementation of Work Reporting Requirements
While HR 1 and the federal government set many standards for work reporting requirements, states have considerable influence over how work reporting requirements are implemented and how they affect adults who rely on Medicaid coverage. States must make important policy and operational decisions – such as which data sources to use to verify compliance with…
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Timeline of Fraud Against Medicaid in Minnesota
In early January 2026, the CMS Administrator, Dr. Mehmet Oz, announced a compliance action imposing large financial penalties on Minnesota ($515 million per quarter going forward), asserting that the state had failed to protect its Medicaid program against fraud. The following month, Vice President J.D. Vance, joined by Dr. Oz, announced a deferral of $259…
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Tracking Wisconsin 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. Wisconsin operates a partial Medicaid expansion, approved under the BadgerCare waiver,…
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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…
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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…
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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…
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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 –…
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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…
