State Policy · WV
West Virginia Advocates Warn H.R. 1 Medicaid Work Requirements Could Drop 40,000-75,000 Enrollees
West Virginians for Affordable Health Care projects that H.R. 1's monthly work reporting requirements, effective January 1, 2027, could terminate coverage for 40,000 to 75,000 of the state's 160,000 Medicaid expansion enrollees — not due to ineligibility, but administrative burdens. The legislation imposes 80-hour monthly work or qualifying activity verification for adults 19-64, with advocates citing Arkansas's 2018 experience where 18,000 people lost coverage in seven months with no employment gains. The advocacy group argues rural hospital support legislation introduced by Sen. Capito contradicts support for H.R. 1, which cuts over $1 trillion from Medicaid over a decade.
Why it mattersWork requirements drive coverage losses through procedural churn rather than eligibility changes, directly reducing MCO enrollment and increasing uncompensated care for providers.