{"id":663347,"date":"2025-05-20T08:00:51","date_gmt":"2025-05-20T12:00:51","guid":{"rendered":"https:\/\/www.kff.org\/?post_type=blog&#038;p=663347"},"modified":"2025-09-09T11:13:48","modified_gmt":"2025-09-09T15:13:48","slug":"implementing-work-requirements-on-a-national-scale-what-we-know-from-state-waiver-experience","status":"publish","type":"post","link":"https:\/\/www.kff.org\/medicaid\/implementing-work-requirements-on-a-national-scale-what-we-know-from-state-waiver-experience\/","title":{"rendered":"Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience"},"content":{"rendered":"<div\n\tclass=\"wp-block-kff-shared-content--standard-layout wp-block-kff-shared-content\">\n\t\n\n<section class=\"wp-block-kff-shared-content-main\">\n\t\t\t<div class=\"post-header\">\n\t\t\t\t\t\n\t<h1 class=\"post-header__title\">Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience<\/h1>\n\n\t\n\t\t\t<div class=\"post-header__meta\">\n\t\t\t\t\t<div>\n\t\t\t\t<span class=\"post-header__meta-label\">\n\t\t\t\tAuthors:\t\t\t\t<\/span>\n\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/elizabeth-hinton\/\">Elizabeth Hinton<\/a> and <a href=\"https:\/\/www.kff.org\/person\/robin-rudowitz\/\">Robin Rudowitz<\/a> \t\t\t<\/div>\n\t\t\t\t<div>\n\t\t\t<span class=\"post-header__meta-label\">Published:<\/span>\n\t\t\t<date>May 20, 2025<\/date>\n\t\t<\/div>\n\t\t<\/div>\n\t\n\t<div class=\"post-header__social-sharing\">\n\t\t<button class=\"post-header__social-sharing__button print\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M4.348 2.5v3.391H2.783A.787.787 0 0 0 2 6.674v4.696c0 .429.353.782.783.782h1.565V14.5h7.304v-2.348h1.565c.43 0 .783-.353.783-.782V6.674a.787.787 0 0 0-.783-.783h-1.565V2.5H4.348Zm.522.522h6.26v2.87H4.87v-2.87ZM2.783 6.413h1.782a.26.26 0 0 0 .085 0h6.697a.26.26 0 0 0 .086 0h1.784c.148 0 .261.114.261.26v4.697c0 .147-.113.26-.26.26h-1.566V9.283H4.348v2.347H2.783a.257.257 0 0 1-.261-.26V6.674c0-.147.113-.261.26-.261Zm9.39.783a.522.522 0 1 0 0 1.043.522.522 0 0 0 0-1.043ZM4.87 9.804h6.26v2.043a.264.264 0 0 0 0 .086v2.045H4.87v-2.043a.261.261 0 0 0 0-.085V9.804Zm1.043.783a.262.262 0 0 0-.265.26.26.26 0 0 0 .265.262h4.174a.26.26 0 1 0 0-.522H5.913Zm0 1.043a.26.26 0 1 0 0 .522h3.13a.26.26 0 1 0 0-.522h-3.13Zm0 1.044a.26.26 0 1 0 0 .522h4.174a.262.262 0 0 0 .264-.261.26.26 0 0 0-.264-.261H5.913Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tPrint\t\t<\/button>\n\t\t<a href=\"mailto:?subject=Implementing%20Work%20Requirements%20on%20a%20National%20Scale%3A%20What%20We%20Know%20from%20State%20Waiver%20Experience&#038;body=https%3A%2F%2Fwww.kff.org%2Fmedicaid%2Fimplementing-work-requirements-on-a-national-scale-what-we-know-from-state-waiver-experience%2F\" class=\"post-header__social-sharing__button\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M2.333 4.25h-.25v9.14h12.5V4.25H2.333Zm1.083 1.693-.353-.2V5.23h10.54v.513l-.353.2L8.333 8.73 3.416 5.943Zm-.353 6.467V6.884l.107.06 5.04 2.857.123.07.123-.07 5.04-2.857.107-.06v5.526H3.063Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tEmail\t\t<\/a>\n\t\t<button class=\"post-header__social-sharing__button copy\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M11.533 2.9c-.615 0-1.23.235-1.697.702L8.502 4.936a2.4 2.4 0 0 0-.575 2.46l.958-.958a1.32 1.32 0 0 1 .371-.748l1.334-1.333a1.331 1.331 0 0 1 1.886 0c.52.52.52 1.365 0 1.885l-1.334 1.333c-.21.21-.474.331-.748.372l-.958.958a2.393 2.393 0 0 0 2.46-.576l1.334-1.333a2.402 2.402 0 0 0 0-3.394 2.393 2.393 0 0 0-1.697-.702Zm-1.61 3.46a.533.533 0 0 0-.367.162l-3.2 3.2a.533.533 0 1 0 .754.754l3.2-3.2a.534.534 0 0 0-.387-.915ZM6.586 7.973a2.388 2.388 0 0 0-1.816.697l-1.334 1.333a2.403 2.403 0 0 0 0 3.394 2.393 2.393 0 0 0 1.697.702c.614 0 1.229-.234 1.697-.702l1.333-1.334a2.4 2.4 0 0 0 .576-2.46l-.959.958a1.32 1.32 0 0 1-.37.749l-1.334 1.333a1.334 1.334 0 0 1-1.886-1.885l1.334-1.334c.21-.21.474-.331.748-.372l.958-.957c-.21-.07-.426-.11-.644-.122Z\" fill=\"#004B88\"\/>\n\t\t\t<\/svg>\n\n\t\t\t<span>Copy Link<\/span>\n\t\t<\/button>\n\t\t\t<\/div>\n\t<\/div>\n\t\t\t\n\n<p class=\"wp-block-paragraph\"><span>On May 18, the House Budget Committee advanced a budget reconciliation <a id=\"menuruc\" class=\"fui-Link ___1q1shib f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1s184ao f1mk8lai fnbmjn9 f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/d1dth6e84htgma.cloudfront.net\/subtitle_d_health_ae3638d840.pdf\" href=\"https:\/\/d1dth6e84htgma.cloudfront.net\/Subtitle_D_Health_ae3638d840.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">bill<\/a> that includes <a href=\"https:\/\/www.kff.org\/tracking-the-medicaid-provisions-in-the-2025-budget-bill\/\">significant changes<\/a> to the Medicaid program. <\/span>As anticipated, Medicaid <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/a-closer-look-at-the-medicaid-work-requirement-provisions-in-the-big-beautiful-bill\/\">work requirement provisions<\/a> are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by <a href=\"https:\/\/www.cbo.gov\/publication\/61420\">$280 billion<\/a> over ten years, nearly half of all estimated Medicaid savings in the bill.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If enacted, all states would be required to condition initial and continued Medicaid <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/5-key-facts-about-medicaid-expansion\/\">expansion<\/a> eligibility on meeting work requirements and to exempt certain individuals from the requirements. KFF <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/understanding-the-intersection-of-medicaid-work-a-look-at-what-the-data-say\/\">analysis<\/a> shows that 92% of Medicaid adults are either working (64%) or have circumstances that may qualify them for an exemption. In previous <a href=\"https:\/\/www.cbo.gov\/system\/files\/2023-04\/59102-Arrington-Letter_LSG%20Act_4-25-2023.pdf\">analysis<\/a>, CBO has found that a Medicaid work requirement would not have any meaningful impact on the number of Medicaid enrollees working.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">States would have flexibility in some areas, including determining how many months to \u201clook back\u201d to verify compliance at application and renewal and whether to require more frequent verifications in between renewal periods. States would be encouraged to use available information (through \u201cdata matching\u201d) to verify individuals\u2019 compliance with the requirements. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><strong>Enrollee Awareness \/ Outreach. <\/strong>Requiring all states to impose Medicaid work requirements would require extensive outreach and education in every state. In Arkansas,&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMsr1901772\">lack of awareness<\/a> and confusion about work requirements (imposed in 2018) were common. Despite robust outreach efforts, many enrollees in Arkansas were&nbsp;<a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/an-early-look-at-implementation-of-medicaid-work-requirements-in-arkansas\/\">not successfully contacted. <\/a>The state noted in a recent waiver request that its complex 2018 work requirement policies caused \u201cconfusion and uncertainty,\u201d resulting in people not knowing whether they were subject to the requirements.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Exemptions. <\/strong>While proponents of work requirements describe them as applying to \u201cable-bodied\u201d adults, some <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/5-key-facts-about-medicaid-expansion\/\">people with disabilities<\/a> (or serious or complex medical conditions) will be subject to the requirements, as they don\u2019t meet criteria to receive SSI but qualify for Medicaid through the ACA expansion. Similar to the proposed federal legislation, Arkansas adopted safeguards including \u201cmedically frail\u201d and \u201cgood cause\u201d exemptions and \u201creasonable accommodations\u201d to try to protect coverage of people with disabilities or other challenges; however, many <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/an-overview-of-medicaid-work-requirements-what-happened-under-the-trump-and-biden-administrations\/\">enrollees struggled<\/a> to access these safeguards and reported difficulties navigating the process to <a href=\"https:\/\/www.kff.org\/report-section\/an-early-look-at-implementation-of-medicaid-work-requirements-in-arkansas-key-findings-9243\/\">qualify for an exemption<\/a>.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Data Matching.<\/strong> The bill raises questions about the capacity and ability of state systems (and staff) to accurately \u201cdata match\u201d (e.g., using payroll and other data) the work or exemption status of millions of individuals. How effective states are with data matching will likely impact how many individuals will need to submit proof of work hours or exemption status, and ultimately the number of individuals at risk of losing coverage. States with older or weaker systems or less integration may be less effective. But even with effective systems, not all work can be verified through existing data sources. More informal work (like \u201cgig work\u201d) may lack traditional employment records or pay stubs and may not be reflected in state data systems. Many people with low incomes may have inconsistent hours or income, which could create additional hurdles. <span class=\"TextRun SCXW126148926 BCX8\"><span class=\"NormalTextRun SCXW126148926 BCX8\">Arkansas <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">successfully <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW126148926 BCX8\">data<\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW126148926 BCX8\"> matched<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\"> about&nbsp;<\/span><\/span><a class=\"Hyperlink SCXW126148926 BCX8\" href=\"https:\/\/www.kff.org\/report-section\/an-early-look-at-implementation-of-medicaid-work-requirements-in-arkansas-key-findings-9243\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW126148926 BCX8\"><span class=\"NormalTextRun SCXW126148926 BCX8\">two thirds<\/span><\/span><\/a><span class=\"TextRun SCXW126148926 BCX8\"><span class=\"NormalTextRun SCXW126148926 BCX8\"> of enrollees<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">, <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">exempting them from reporting work hours or exemption status. Among those who had to <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">actively report<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">, <\/span><\/span><a class=\"Hyperlink SCXW126148926 BCX8\" href=\"https:\/\/www.urban.org\/sites\/default\/files\/2025-03\/Assessing-Potential-Coverage-Losses-among-Medicaid-Expansion-Adults-under-a-Federal-Medicaid-Work-Requirement.pdf#:~:text=Range%20based%20on%20enrollee%20reporting%20patterns%20for,the%20work%20reporting%20requirement.%20Estimates%20are%20rounded.\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW126148926 BCX8\"><span class=\"NormalTextRun SCXW126148926 BCX8\">about 70%<\/span><\/span><\/a><span class=\"TextRun SCXW126148926 BCX8\"><span class=\"NormalTextRun SCXW126148926 BCX8\"> did not <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">obtain an exemption or report compliance, <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">ultimately<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\"> resulting<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\"> in <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">over <\/span><span class=\"NormalTextRun SCXW126148926 BCX8\">18,000 people<\/span><span class=\"NormalTextRun SCXW126148926 BCX8\"> losing coverage.<\/span><\/span><span>&nbsp;<\/span>&nbsp;Arkansas recently highlighted (in its new waiver request) that limitations with \u201cdata matching\u201d led to some individuals with medical conditions or disabilities that prevented them from working to \u201cfall through the cracks\u201d when the state implemented its work policies in 2018.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Verification at Application. <\/strong>Only one state (Georgia) has experience conditioning Medicaid eligibility at application on meeting work requirements. Over 18 months since Georgia launched its \u201cPathways\u201d program, the state has only enrolled <a href=\"https:\/\/www.georgiapathways.org\/data-tracker\">7,000<\/a> individuals\u2014far short of the state\u2019s own estimated enrollment of <a href=\"https:\/\/www.medicaid.gov\/medicaid\/section-1115-demonstrations\/downloads\/ga-pathways-to-coverage-pa1.pdf\">25,000 <\/a>adults in the first year and&nbsp;<a href=\"https:\/\/www.medicaid.gov\/Medicaid-CHIP-Program-Information\/By-Topics\/Waivers\/1115\/downloads\/ga\/ga-pathways-to-coverage-ca.pdf\">64,000<\/a>&nbsp;over 5 years. The state\u2019s <a href=\"https:\/\/www.medicaid.gov\/medicaid\/section-1115-demonstrations\/downloads\/ga-pathway-pa-04282025.pdf\">interim waiver evaluation<\/a> revealed that work requirements had a significant impact on lowering program enrollment, particularly for adults ages 50-64.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Administrative Costs. <\/strong>Implementing work requirements involves complex systems changes (e.g., developing or adapting eligibility and enrollment systems), enrollee outreach and education, and staff training. According to <a href=\"https:\/\/www.gao.gov\/products\/gao-20-149\">GAO<\/a>, federal and state administrative costs to implement Medicaid work requirements are sizeable. Recent <a href=\"https:\/\/www.propublica.org\/article\/georgia-medicaid-work-requirement-pathways-to-coverage-hurdles\">investigative reporting<\/a> found Georgia\u2019s \u201cPathways\u201d program has cost the federal and state government more than $86 million (as of the end of 2024), with three-quarters spent on consulting fees. GAO recently <a href=\"https:\/\/kffhealthnews.org\/news\/article\/gao-federal-watchdog-medicaid-work-requirement-analysis-georgia\/\">confirmed<\/a> it is examining the costs of Georgia\u2019s Pathway program, with a report expected this fall.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Targeted Work Supports.<\/strong> Research has <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/5-key-facts-about-medicaid-work-requirements\/\">shown<\/a> that access to affordable health insurance and care promotes individuals\u2019 ability to obtain and maintain employment, helping people manage chronic conditions and supporting people\u2019s ability to work jobs that may be physically demanding. While most Medicaid adults <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/understanding-the-intersection-of-medicaid-and-work-an-update\/\">are already working<\/a>, some states have launched initiatives to support employment for Medicaid enrollees, without making employment a condition for eligibility. <a href=\"https:\/\/www.kff.org\/report-section\/supporting-work-without-the-requirement-state-and-managed-care-initiatives-issue-brief\/\">Montana<\/a> created \u201cHELP-Link,\u201d a free voluntary workforce support program for eligible expansion adults (funded only with state dollars), which also helps participants address barriers to work including transportation and child care. A <a href=\"https:\/\/mthf.org\/wp-content\/uploads\/2019\/01\/Economic-Impact-of-MedEx-in-MT_1.28.19-FINAL.pdf\">study<\/a> of Montana\u2019s Medicaid expansion, including HELP-Link, found an increase of four to six percentage points in labor force participation among low-income, non-disabled adults ages 18-64 following expansion, compared to higher-income non-Medicaid Montanans and to the same population in other states. While federal Medicaid funds cannot be used for work supports (e.g., to help individuals overcome barriers to work like child care and transportation), CBO has <a href=\"https:\/\/www.cbo.gov\/publication\/57702\">found<\/a> that targeted work supports can help boost employment. Unlike <a href=\"https:\/\/www.kff.org\/from-drew-altman\/making-sense-of-medicaid-work-requirements\/\">welfare reform<\/a>, the Medicaid work requirement in the reconciliation bill does not provide supports like child care, transportation, or job training.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The bill seeks to implement work requirements on a national scale, including requiring states to verify individuals\u2019 monthly work status and implement a long list of exemptions\u2014policies that proved challenging for Arkansas and Georgia to operationalize and led to <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/state-data-for-medicaid-work-requirements-in-arkansas\/\">18,000 people<\/a> losing coverage in Arkansas, <a href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/5-key-facts-about-medicaid-work-requirements\/\">without increasing<\/a> employment. CBO\u2019s hefty estimated federal savings from the proposed national Medicaid work requirements signals an expectation that the draft policies under consideration would result in significant coverage loss and prevent many people from enrolling.<\/p>\n\n\t<div class=\"post-footer\">\n\t<div class=\"post-footer__title\">More On<\/div>\n\t<div class=\"post-footer__links\">\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/medicaid\/\">\n\t\t\t\tMedicaid\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/state-health-policy-data\/\">\n\t\t\t\tState Health Policy and Data\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/access-to-care\/\">\n\t\t\t\tAccess to Care\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/arkansas\/\">\n\t\t\t\tArkansas\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/eligibility\/\">\n\t\t\t\tEligibility\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/georgia\/\">\n\t\t\t\tGeorgia\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/medicaid-work-requirements\/\">\n\t\t\t\tMedicaid Work Requirements\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/state-budgets\/\">\n\t\t\t\tState Budgets\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/waivers\/\">\n\t\t\t\tWaivers\t\t\t<\/a>\n\t\t\t<\/div>\n<\/div>\n\t<\/section>\n\n\n<section class=\"wp-block-kff-shared-content-sidebar\">\n\t\t\t\n\t\t\n<div class=\"wp-block-kff-shared-related-content--green wp-block-kff-shared-related-content\">\n\t<h2 class=\"wp-block-kff-shared-related-content__heading\">Also of Interest<\/h2>\n\t<div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/medicaid\/5-key-facts-about-medicaid-work-requirements\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\t5 Key Facts About Medicaid Work Requirements\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/medicaid\/understanding-the-intersection-of-medicaid-and-work-an-update\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tUnderstanding the Intersection of Medicaid and Work: An Update\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/medicaid\/understanding-the-intersection-of-medicaid-and-work-an-update\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tUnderstanding the Intersection of Medicaid and Work: An Update\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\t\t\t<\/section>\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.<\/p>\n","protected":false},"author":155412890,"featured_media":663416,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"authors":[{"type":"foundation","id":166366,"name":""},{"type":"foundation","id":49505,"name":""}],"exhibits":[],"jetpack_post_was_ever_published":false,"ep_exclude_from_search":false,"_classifai_error":"","_classifai_text_to_speech_error":"","hide_from_search":false,"show_featured_image":false,"subheading":"","tag":"","search_keywords":"Blog, work requirements, 1115 waiver, data matching, reconciliation, 10699, Elizabeth Hinton, Robin Rudowitz","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"shortlink":"","footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"enabled":false},"version":2}},"categories":[140023,579145479],"tags":[632330,50255,748294,22721,579144924,1301486,522163],"series":[417697727],"partner":[],"program":[417697747],"content-types":[579145488],"class_list":["post-663347","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicaid","category-state-health-policy-data","tag-access-to-care","tag-arkansas","tag-eligibility","tag-georgia","tag-medicaid-work-requirements","tag-state-budgets","tag-waivers","series-medicaid-watch","program-program-on-medicaid-uninsured","content-types-policy-watch"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience | KFF<\/title>\n<meta name=\"description\" content=\"On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kff.org\/medicaid\/implementing-work-requirements-on-a-national-scale-what-we-know-from-state-waiver-experience\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience | KFF\" \/>\n<meta property=\"og:description\" content=\"On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. 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