Alliance Note: The Center for Health Care Strategies has released implementation resources for states on the new federal Medicaid work requirements. The resources outline key policy details and practical strategies to help states reduce administrative burden and minimize coverage disruptions for people impacted who receive Medicaid.
| May 27, 2026 Federal Medicaid Work Requirements: Implementation Resources for States The 2025 budget reconciliation act (P.L. 119-21) introduced new federal work requirements for certain Medicaid expansion members, effective January 2027. Some states have already begun implementing work requirements, or plan to do so before the deadline. Implementing the policy poses challenges for states, including an increased risk of coverage disruption for members. However, states can take proactive steps to help eligible members maintain coverage while minimizing additional administrative burden on Medicaid members and state agency staff. The following Center for Health Care Strategies resources outline key details about the new requirements and offer practical approaches to implementation focused on reducing administrative burden and maintaining coverage for eligible members. A Summary of Federal Medicaid Work Requirements New federal Medicaid work requirements have significant implications for members, state agencies, health care providers, and managed care organizations. This Policy Cheat Sheet synthesizes key details about the requirements, including timeline, populations impacted, exemption categories, and more. Read more Data and Analytic Approaches for Medical Frailty Exemptions to Federal Medicaid Work Requirements Federal Medicaid work requirements include exemptions for certain groups, including medically frail individuals. This tipsheet features implementation considerations that can help streamline state adoption of the medical frailty exemption and minimize Medicaid application and renewal barriers for medically frail individuals. Read more Building Nimble Procurement Approaches for State Medicaid Tech Systems In planning for work requirements, many states are seeking more flexible and agile procurement approaches for eligibility and enrollment systems. This tipsheet draws on strategies from Alaska and national civic tech experts to outline best practices states can use to improve their processes within existing procurement authorities. Read more Aligning Work Requirements Across SNAP and Medicaid to Support Public Benefits Continuity The Supplemental Nutrition Assistance Program (SNAP) and Medicaid serve largely overlapping low-income populations. This brief compares key features of federal work requirements in both SNAP and Medicaid, and outlines strategies for Medicaid agencies, SNAP-administering organizations, and other stakeholders to coordinate implementation across both programs. Read more Strengthening Cross-Agency Collaboration Across Medicaid and Other State Partners to Support Work Requirements Implementation To support effective work requirements implementation, Medicaid agencies can partner with other state agencies to align necessary systems changes and processes. This brief outlines opportunities for Medicaid agencies to collaborate with partners in labor, education, corrections, SNAP, and other agencies to effectively address implementation challenges. Read more Connecting Medicaid Members to Work: Expanding Access to Evidence-Based Employment Models Although workforce programs operate outside Medicaid, new work requirements create an impetus for states to connect members with evidence-based employment supports. This Evidence Roundup outlines the evidence behind workforce and supported employment programs and includes resources state agencies can use to prepare for implementation. Read more Engaging Medicaid Members and Community-Based Organizations in Work Requirements Implementation Community-based organizations can be major assets to states in communicating with Medicaid members. This brief outlines approaches states can use to partner directly with members and community-based organizations in implementing work requirements that reflect community input and minimize coverage disruptions. Read more Home | Focus Areas | Resources | Blog | About Us |