Medicaid

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.

In October 2024, the Centers for Medicare and Medicaid Services (CMS) approved the first ever Section 1115 waiver demonstration amendments that would allow Medicaid and CHIP coverage of traditional health care practices for American Indian or Alaska Native (AIAN) people in Arizona, California, New Mexico, and Oregon. This Waiver Watch reviews disparities in health and health care for AIAN people and summarizes the key features of the approved waivers.

This policy watch provides an update on the latest trends in children’s routine vaccination and exemption rates and discusses how these trends could be impacted by the administration change.

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.

This page displays an interactive map of the current status of state decisions on the Affordable Care Act’s Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

With Donald Trump returning to the presidency, the future of Medicaid is uncertain. While Medicaid did not receive a lot of attention directly during the campaign, Trump’s first term can shed light on potential changes that could be implemented administratively without Congress.

This brief examines the implications of rising prescriptions for costly GLP-1 drugs for state Medicaid programs as more states consider covering the drugs for weight loss. It examines recent trends in Medicaid prescriptions and gross spending on GLP-1s, and explores the potential implications of expanding coverage obesity drugs for Medicaid programs.