Trump administration lets states wait until July to enforce Medicaid work requirement
The requirement still technically starts Jan. 1, but CMS says states may choose not to remove anyone or deny coverage before July 1.
The Trump administration announced on Friday a six-month delay in enforcing the work requirement. The requirement is part of Republicans' "big, beautiful" tax and spending law. It asks many adults under 65 to show at least 80 hours a month of work, volunteering or school.
It still technically starts Jan. 1. The Centers for & Medicaid Services () told states they may choose not to remove anyone or deny coverage for failing it until July 1. CMS calls this an "optional hold harmless period."
States must still begin checking on Jan. 1 whether enrollees meet the rules. Dan Brillman, who oversees Medicaid at CMS, said states "have made real progress." NBC News reports the White House declined to comment.
Pressure for a delay had been building. Democratic Sen. Ron Wyden and Rep. Frank Pallone Jr. wrote to CMS Administrator Dr. Mehmet Oz in a letter dated Wednesday, asking for more time. NBC reports five Democratic governors asked Health Secretary Robert F. Kennedy Jr. to postpone, and a federal judge blocked part of the rule covering medically frail people.
Democrats take control of both chambers of in January and have said they want to roll back the requirements. Nebraska began enforcing in May.
- 80 hours a monthminimum work, volunteering or school time the law requiresNBC News
- 533Nebraska enrollees due for renewal in July and August who were denied continuing coverage, per preliminary dataThe Independent
- 43of those 533 denied in Nebraska, people who lost coverage for not meeting the new requirementThe Independent
- 5.3 millionmore people uninsured by 2034 from the work requirements, per the CBONBC News
Three sides of the story
8 news outlets reported this · Little coverage from conservative outlets
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Liberal4 outlets
Delay as a reprieve for states and enrollees
NBC News calls the delay "a striking turn" for an administration that has defended the policy for months, and notes the requirement technically still starts Jan. 1. It quotes Brillman saying states "have made real progress," reports that the White House declined to comment, and gives the last word to Sarah Lueck of the Center on Budget and Policy Priorities: "Today's news lets states delay the harm." Axios, in a breaking-news item, says the pause covers rules state officials warned they were not ready for, and that could cost "millions of people" their coverage.
It adds that the concern is people losing coverage because they do not understand reporting rules. The New York Times says poor adults had been due to lose insurance from Jan. 1 unless they proved they worked, and states can now wait until July. The Independent runs an Associated Press report quoting Kathy Hempstead of the Robert Wood Johnson Foundation, who expects fewer people to lose coverage through administrative failures.
It also gives preliminary Nebraska figures for enrollees due for renewal in July and August: 533 denied continuing coverage, 43 of them for not meeting the requirement.
Center3 outlets
States get more time to build systems
Stateline leads with the announcement that states can take six more months, and quotes Brillman at length: if a state can use data to show someone works or qualifies for an exclusion, that person "should not have to track down paperwork." It lists the law's exemptions, from pregnant people to those released from incarceration in the last 90 days, and cites the Wyden and Pallone letter. The Seattle Times runs the Associated Press report, as the Independent does.
It says states have been scrambling to prepare, quotes Kate McEvoy of the National Association of Medicaid Directors saying leaders "appreciate the additional flexibility" from CMS, and adds that the pause could give Congress room to consider changes. The Hill's report says the administration is giving states an extra six months to prepare and calls the requirements "controversial." A second Hill item describes two top Democrats pressing CMS to give states more time.
- Stateline: States have 6 more months to implement Medicaid work requirement, administration says
- The Seattle Times: US gives states another 6 months before they have to remove people from Medicaid for not working
- The Hill: Trump administration delays Medicaid work requirement enforcement
- The Hill: Top Dems: CMS must give states more time on Medicaid work rules
Conservative1 outlet
Hospitals bracing for work-requirement coverage losses
The New York Post, in an article published Nov. 11, says hospitals are "reportedly panicking" over the January requirements and that some lawmakers are pushing for a two-year delay. It says a coalition of Democrats is calling for that delay. The Post puts the CBO's estimate of savings at $326 billion over 10 years and says New York's 's office expects 475,000 patients to lose care.
It quotes Dr. Ted Long of Health + Hospitals, "This will be a crisis," and Nicole Harper of Eskenazi Health in Indiana, "We're bracing for impact." It also cites Sen. John Kennedy of Louisiana, who sees the changes as a way to reform a broken system. The Post says CMS did not immediately respond to a request for comment.
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- CBO estimate of federal savings from the work requirements
- NBC News: $317 billion
- New York Post: $326 billion over 10 years
In states that use the hold harmless period, no Medicaid enrollee will lose coverage for failing the requirement until July, NBC News reports. The delay is optional, and Kathy Hempstead of the Robert Wood Johnson Foundation says it is unclear which states will use it. The Associated Press reports the rule applies only to adults in the voluntary expansion that 40 states adopted. States using the period still start checking on Jan. 1, NBC reports.
All sources: 10 articles from 8 outlets
Liberal (5)
- Axios: Trump administration delays Medicaid work requirements by six months
- NBC News: Trump administration delays Medicaid work requirements by six months
- The Independent: US gives states another 6 months before they have to remove people from Medicaid for not working
Center (4)
- Stateline: States have 6 more months to implement Medicaid work requirement, administration says
- The Hill: Trump administration delays Medicaid work requirement enforcement
- The Hill: Top Dems: CMS must give states more time on Medicaid work rules
- The Seattle Times: US gives states another 6 months before they have to remove people from Medicaid for not working
Conservative (1)
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