The 2025 budget reconciliation bill (H.R. 1) requires states to implement work reporting requirements (WRRs) for Medicaid expansion adults, as well as adults covered by partial adult waiver expansions in Georgia and Wisconsin, starting in 2027. In 43 states including the District of Columbia, unless they are exempt, expansion adults must complete and report at least 80 hours per month of work or other qualifying activities when they apply for Medicaid, and every six months when they renew their eligibility. A study from the Urban Institute estimates that between 4.9 to 10.1 million people will lose coverage by 2028 as a consequence of this new requirement, as well as more frequent renewals required by the new law.
States have a short timeline to upgrade their eligibility and enrollment systems, comply with new requirements, and inform affected families. Some standards are set at the federal level, but states also have significant influence over how the work reporting requirement is implemented, making state-level decisions important for how many people will keep or lose Medicaid coverage.
This landing page tracks the implementation of work reporting requirements across states, including state-level policy and operational decisions, administrative and technology costs, and the resulting impact on Medicaid enrollment. We will update resources continuously as the rollout progresses.
Federal Work Reporting Requirements under H.R. 1
This page includes information and federal guidance on Medicaid work reporting requirements established under H.R. 1. Resources will be updated as further federal guidance is released.
Medicaid Enrollment Trends
This page includes a comprehensive 50-state Medicaid and CHIP enrollment tracker with timely data on enrollment trends for children, adults, and Medicaid expansion adults, where applicable.
State Implementation of Work Reporting Requirements
This page includes data and resources to monitor implementation of work reporting requirements across states, including state-level policy and operational decisions.
State Administration and Technology Costs
This page includes more details on the administrative and technology costs that state and federal governments incur to comply with work reporting requirements.
State and Enrollee Materials
This page includes materials or webpages developed by state Medicaid agencies for Medicaid beneficiaries or those who work with beneficiaries.
- Healthcare Management Associates: Connecting the Dots: Medicaid Community Engagement Requirements and State Readiness for 2027 – April 2026
- KFF: A Closer Look at California’s Plans to Implement Work Requirements While Facing Major Budget Shortfalls Amid Cuts in Federal Medicaid Funding – April 2026
- Urban: Ensuring Continuous Coverage for Pregnant and Postpartum Medicaid Enrollees Under OBBBA – March 2026
- Urban: Projected Reductions in Medicaid Expansion Enrollment Under OBBBA’s Work Requirements and Six-Month Redeterminations – March 2026
- KFF: Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements – March 2026
- RAND: State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act – February 2026
- CBPP: State Choices in Medical Frailty Work Requirement Exemption Can Keep Eligible People Covered – February 2026
- NHELP: State Implementation of Medicaid Work Requirements | Guidelines for Public Records Requests – February 2026
- CBPP: Assessing the Medicaid Work Requirement Vendor Landscape – February 2026
- NHELP: Timely Tips to Safeguard Medicaid
- KFF: A Closer Look at the Work Requirement Provisions in the 2025 Federal Budget Reconciliation Law – July 2025
- Inseparable: Medicaid, Mental Health, and H.R. 1: A State Guide to Using Data for Community Engagement Determinations