Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
Work requirements in Medicaid may be considered as part of a broader federal legislative package of potential changes to Medicaid designed to significantly reduce federal Medicaid spending. A draft bill introduced in the U.S. House of Representatives in February 2025 includes a minimum work requirement for certain adults enrolled in Medicaid as a condition of coverage.
Even as the federal legislative debate evolves, some states are again pursuing Medicaid work requirements through Medicaid demonstration waivers. The first Trump administration encouraged and approved “Section 1115” demonstration waivers that conditioned Medicaid coverage on meeting work and reporting requirements, approving 13 state work requirement waivers. Only Arkansas implemented such requirements with consequences for noncompliance, which resulted in over 18,000 people losing coverage. These approvals were either rescinded by the Biden administration or withdrawn by states, and Georgia is the only state with a Medicaid work requirement waiver in place (following litigation over the Biden administration’s attempt to stop it). While work requirement waivers were the subject of litigation during the Trump and Biden administrations, the Supreme Court never ruled on the issue, leaving it open for future administrations.
For more information on the history and research regarding Medicaid work requirements, see additional KFF resources:
- A detailed overview and history of Medicaid work requirements (2022)
- A recap of the landscape of work requirement approvals and pending requests at the end of President Trump’s first term (2024)
- An analysis of the work status and characteristics of Medicaid enrollees (2025)
- A short brief highlighting five key facts about Medicaid work requirements, including what the research shows about the impact of work requirements (2025)
The map below identifies approved and pending work requirement waivers (submitted to CMS since January 2025) as well as states with proposals that have been released at the state-level for “public comment.” The table below the map provides more detailed state waiver information and a summary of recent state legislative activity involving work requirements.
The table below provides more detailed state waiver information for waivers that are approved and pending at the federal level, as well as activity at the state-level once a waiver proposal has been released for state-level “public comment.” This table also lists states with legislative activity involving work requirements, once a bill has passed out of committee (typically the first step of the legislative process). Some states require state legislative action before Section 1115 waiver requests can be submitted by the state Medicaid agency to CMS for federal approval and others do not.
