Work Requirements

This data note documents differences by sex in the work status of adult Medicaid enrollees ages 19-64 who were not receiving Supplemental Security Income (SSI) and were not dually eligible for Medicare in 2023, and highlights differences by parent status.

Amid discussion of changes to the Medicaid program, most of the public say that Medicaid is important to their local communities. About two in ten favor cuts to Medicaid spending. Support for Medicaid cuts remain low even among typically conservative groups such as Republicans, Trump voters, and those living in rural communities. The poll also gauges the impact of arguments for and against Medicaid work requirements and reductions to federal spending on ACA expansion.

Work requirements in Medicaid have resurfaced as part of a broader legislative package of potential changes to Medicaid designed to significantly reduce federal Medicaid spending. This brief highlights five key facts about Medicaid work requirements, including the share of Medicaid enrollees who currently work, what research shows about the impact of work requirements, and the administrative burdens associated with implementing them.

In 2025, many issues are at play that could affect Medicaid coverage, financing, and access to care.

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…