Appeals Court Strikes Decisively at the Heart of Administrator Verma’s Medicaid Agenda

In a decision which warmed my heart on a cold Valentine’s Day here in Washington, the federal Court of Appeals issued an unanimous opinion striking down the Arkansas work requirements waiver. In doing so, it upheld district court Judge Boasberg’s decision vacating the Arkansas’ Section 1115 waiver (including most famously Medicaid work requirements) because it…

February 14, 2020

By

Joan Alker

Blog

South Carolina Becomes First State to Impose Harmful Work Requirements Primarily on Poor Parents

I had held out a little sliver of hope that the Trump Administration would not cross this line but today those hopes were extinguished when CMS Administrator Verma traveled to South Carolina to personally deliver the news to South Carolina Governor McMaster that his state would be the first in the nation to apply a…

December 12, 2019

By

Joan Alker

Blog

Some States’ Letters to CMS on Medicaid Work Requirements Double Down

Last month, CMS began taking steps to get rid of Medicaid section 1115 work requirement waivers as my colleague Joan Alker has written about. The Biden Administration sent letters to states with approved work requirements that “preliminarily” disapproved the policy on the basis of the COVID-19 pandemic and uncertainty of its aftermath on health and…

March 23, 2021

By

Allexa Gardner

Blog

CMS Weaponizes Fraud Against Medicaid in Minnesota: Part 2

At a White House press conference last Wednesday, Vice President J.D. Vance, newly tasked with leading a war on fraud, announced that “we have decided to temporarily halt” $259 million in federal matching payments to the state of Minnesota due to fraud against its Medicaid program. He emphasized: “…we don’t want to do this. We…

March 2, 2026

By

Andy Schneider

Blog

Medicaid Work Reporting Requirements: States Ask a Federal Court to Protect Medically Frail Individuals from CMS Overreach

On June 3, CMS issued an Interim Final Rule (IFR) misinterpreting the work reporting requirements enacted last July in H.R. 1. The H.R. 1 provisions were bad enough, but as my colleague Leo Cuello has explained, the IFR imposes policies on states and individuals that the Congress did not enact. Most notably, the IFR makes…

July 2, 2026

By

Andy Schneider

Blog

Medicaid Wars: Rescind and Withdraw (Episode II)

The Biden Administration has a long list of bad Medicaid policies to unwind. As chronicled in Episode I, the groundwork for the unwinding was laid in a Presidential Executive Order, “Strengthening Medicaid and the Affordable Care Act,” issued on January 28. Among other things, the E.O. directs the Secretary of HHS to review section 1115 demonstrations and…

March 19, 2021

By

Andy Schneider

Blog

Evaluating the Administration’s Narrative on Medicaid Work Reporting Requirements

It turns out that last week was Never Mind Week. Who would have guessed? On Monday the Administration released its “Budget for a Better America,” proposing to cut federal Medicaid spending by nearly $1.5 trillion (with a “t”) over the next ten years. These cuts included a mandate that state Medicaid programs require that “able-bodied,…

March 19, 2019

By

Andy Schneider

Blog

Medicaid Wars: The Unwinding (and Litigation) Continues (Episode IV)

It’s been seven months and change since the Biden Administration took office. What it found waiting for it on January 20 was not just a crisis of democracy and a global pandemic and a surge of unaccompanied children at the border, but also a large pile of policy intended to undercut the Administration’s ability to…

August 26, 2021

By

Andy Schneider

Blog

Proposed Rule Would Make Matters Worse for Immigrant Children Held in Detention – Comments Due Nov. 6

About a year ago, the Administration reversed longstanding immigration policy and started separating children from their parents at the US-Mexico border. Over just a few months, thousands of children were separated from their parents. The issue drew a lot of media attention, as medical and child welfare experts pointed out that research shows the Administration…

September 18, 2018

By

Kelly Whitener

Blog

Arkansas’ Medicaid Work Reporting Rules Lead to Staggering Health Coverage Losses

Earlier this week, the state of Arkansas released its final round of data for 2018 for its controversial work reporting requirement policy. The data shows that an additional 1,232 adults lost their Medicaid coverage at the end of December, bringing the total Medicaid coverage loss since August to 18,164. The news motivated me to take…

January 18, 2019

By

Joan Alker

Research & Reports

New Federal Medicaid Work Reporting Requirements Rule Threatens Coverage for Vulnerable Americans: An Explainer of the Interim Final Rule

On June 1, 2026, the Centers for Medicare & Medicaid Services (CMS), published the Interim Final Rule with Comment (CMS-2454-IFC, hereafter referred to as the IFR) “Medicaid Program; Community Engagement Requirement for Certain Individuals” as required by the 2025 Budget Reconciliation Law (hereafter referred to as H.R. 1). States that have expanded Medicaid to adults…

July 16, 2026

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