Medicaid work requirement rules published by Trump’s CMS

Tara covers the business of health care. Her stories focus on hospitals, doctors, and how their business practices affect patients — especially when private equity gets involved. She also writes about health insurance and ideas for improving our broken health system. You can reach Tara on Signal at tarabannow.70.

WASHINGTON — On Monday, the Trump administration released a long-awaited document detailing new rules requiring many adult Medicaid recipients to work or attend school to qualify for coverage.

The Centers for Medicare and Medicaid Services issued regulations that provide the framework for states to implement these Medicaid work requirements. The guidelines specify exemptions, processes for verifying exemptions, and state reporting obligations. These work requirements, introduced in President Trump’s 2025 tax cut legislation, are favored by Republican lawmakers but largely opposed by Democrats and advocates for the seriously ill or economically disadvantaged.

Initial estimates projected that the work requirements policy would cut federal Medicaid expenses by $326 billion and result in 5.3 million people losing their Medicaid coverage. On the same day, a division of the federal Department of Health and Human Services released a research brief suggesting that the rules could encourage employment, potentially lifting 1.6 million to 2.9 million people out of poverty.

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