States Vexed By Federal Medicaid Work Mandate: States of Play

June 5, 2026, 6:34 PM UTC

States Vexed by Stricter Medicaid Demands

Photographer: by Bryan Dozier / Middle East Images via AFP

The Trump administration’s blueprint for Medicaid work requirements threw a wrench into some states’ plans by going beyond what Congress mandated, Ian Lopez and Ganny Belloni report.

Republicans’ sweeping tax and spending law included mandatory work requirements for Medicaid beneficiaries to be overseen by states. But the administration’s rule this week on carve-outs for the work requirements limited eligibility to those who show they’re too impaired to work, which went beyond states’ expectations.

It’s “a pretty big pivot that states are now going to have to deal with,” said Allison Orris of the ...

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