Medicaid Work Requirements: What Happened under the Trump and Biden Administrations?
In a new brief, KFF analysts explain and summarize the recent history of efforts to make work requirements a condition of eligibility for Medicaid in some states.
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In a new brief, KFF analysts explain and summarize the recent history of efforts to make work requirements a condition of eligibility for Medicaid in some states.
The Trump Administration aimed to reshape the Medicaid program by newly approving Section 1115 demonstration waivers that imposed work and reporting requirements as a condition of Medicaid eligibility. However, courts struck down many of these approvals and the Supreme Court recently dismissed pending challenges in these cases. Available implementation data suggests that work requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals.
Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. This issue brief summarizes waiver priorities and actions under the Biden Administration as well as pending waiver themes and other issues to watch. If the Build Back Better Act (BBBA) fails to pass or is narrowed significantly, Medicaid waivers and other administrative actions may be a key tool for the Biden Administration to advance policy priorities absent legislation.
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