Work Requirements

This Medicaid waiver tracker page aggregates tracking information on pending and approved Section 1115 Medicaid waivers. It includes resources such as an overview figure, detailed waiver topic tables, and explanatory briefs.

In this column, KFF President and CEO Drew Altman examines the data and history around adding work requirements to Medicaid and why the administrative burdens it imposes may offset any savings even for states that ideologically favor such an approach.

With Donald Trump returning to the presidency and Republican control of the Senate and House, work requirements are likely to be back on the agenda—through federal legislation or Medicaid waivers. This issue brief highlights the history of Medicaid work requirements, describes recent state activity to advance work requirement policies, and recaps the landscape of work requirement approvals and pending requests at the end of President Trump’s first term.

Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome of the November 2024 presidential election as a new administration could focus on different priorities, rescind existing guidance, or withdraw already-approved waivers. This waiver watch summarizes five key areas of difference in 1115 waiver policy and waiver approvals under the Trump and Biden-Harris administrations.

This policy watch examines Mississippi’s recent Medicaid expansion activity, what expansion could mean for residents and the economy, and key developments to watch.

In this JAMA Health Forum column, Larry Levitt examines differences in the Republican presidential candidates’ records and positions on health issues, including Medicaid and abortion, that could play a role in the primaries and would set up a sharp contrast in the general election against President Biden.

A new KFF analysis finds that an estimated 1.7 million Medicaid enrollees could become ineligible for federal Medicaid under proposed work requirements and presents state-by-state projections, based on estimates of coverage loss from the Congressional Budget Office (CBO). States could continue to provide Medicaid to those enrollees but would not…

On April 26, 2023, the House of Representatives passed a Republican debt ceiling bill (HR 2811, the Limit, Save, Grow Act of 2023) that includes a requirement for states to implement work requirements for certain Medicaid enrollees. We provide estimates for the rate of Medicaid eligibility loss based on Congressional Budget Office (CBO) projections as well as estimates for the cost to states if they maintained coverage for all ineligible participants in 2024.

Three experts joined series moderator Larry Levitt in a discussion about work and reporting requirements in public programs such as Medicaid, their effects on enrollment and employment, and what we can expect on the state and federal levels regarding the future of Medicaid work requirements.

To provide context to work requirement debates, this brief explores work status and characteristics of Medicaid enrollees.