Federal Policy · CA
H.R. 1 Imposes Federal Medicaid Work Requirements, Cuts $1 Trillion Over Decade
In July 2025, President Trump signed H.R. 1 into law, reducing federal Medicaid funding by $1 trillion over ten years and establishing a federal work requirement for certain adult enrollees. The law mandates that covered adults work, attend school, or volunteer to maintain eligibility. The requirements apply to non-exempt adult populations and represent a fundamental shift from prior waiver-based work requirement approaches to a statutory federal mandate. States must implement compliance tracking and reporting systems, affecting MCO enrollment verification, eligibility redeterminations, and coverage continuity processes.
Why it mattersManaged care organizations must build new systems to verify and document member compliance with work requirements, anticipate enrollment churn and disenrollment volumes, and adjust actuarial assumptions for membership stability and medical loss ratios.