Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State

The 2025 budget reconciliation legislation, signed into law on July 4, requires states to condition Medicaid eligibility for adults in the ACA Medicaid expansion group on meeting work requirements starting January 1, 2027, with the option for states to implement requirements sooner.

Prior to the passage of the federal reconciliation legislation and since January 2025, some states have shown renewed interest in pursuing work requirement policies through 1115 waivers. The first Trump administration encouraged and approved 1115 demonstration waivers that conditioned Medicaid coverage on meeting work requirements which were subsequently rescinded by the Biden administration or withdrawn by states. Currently, Georgia is the only state with a Medicaid work requirement waiver in place following litigation over the Biden administration’s attempt to stop it. Pending work requirement waivers may need to be altered to conform with the budget reconciliation legislation framework.

The map below identifies approved (Georgia) 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.

For more information on Medicaid work requirements, see additional KFF resources:

• An overview of the work requirement provisions in the 2025 budget reconciliation legislation, including key operational & implementation questions (2025)
• Analyses 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)
• A detailed history of Medicaid work requirements (2022)

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.