Rural Communities at Greater Risk of Harmful Impacts from New Medicaid Work Reporting Requirements

In 2025, Congress enacted H.R. 1, requiring work reporting as a condition of Medicaid eligibility in the 41 states that expanded coverage to low-income adults under the ACA, plus Wisconsin and Georgia. The law affects Medicaid expansion populations in those states. Rural communities face heightened risk of coverage loss due to barriers in meeting reporting requirements. The policy represents a significant shift in Medicaid eligibility standards, imposing new administrative and compliance obligations on state agencies and creating potential churn for health plans managing expansion populations.

Managed Care