Grappling with Healthcare Changes: States Begin Preparing for the Implementation of Medicaid Work Reporting Requirements Under H.R. 1

Track your state’s readiness to implement the changes under H.R. 1 at the CFF’s tracker and find your state-specific name for its Medicaid and CHIP programs.

Currently under discussion in many states around the country are the work reporting requirements included in H.R. 1. These requirements will make it harder for patients to prove their eligibility for coverage, and in some states that previously tried implementing these requirements, like Arkansas, they resulted in 18,000 adults losing coverage and no substantial increases in employment.

After H.R. 1 became law in July, the Center for Children and Families (CFF) at Georgetown University’s McCourt School of Public Policy conducted a study and found that more than half of states in the country are poorly prepared to implement these requirements, including the following states that indicated the greatest levels of risk:

Despite these potential challenges, some states are already beginning to work on their implementation plans, because under the law, states are allowed to start their programs before the official nation-wide date of January 1st, 2027. As of this article’s publication date, Georgia is the only state with active work requirements, although Utah, Arizona, Iowa, Arkansas, Ohio, and South Carolina have all submitted waivers to the Department of Health and Human Services to begin their programs. 

Given the short timeframe that states will have to implement these requirements, it is likely that significant difficulties are on the horizon for state Medicaid programs and our patients who use them. It will be very important to stay informed about your state’s progress toward these requirements and any changes that may impact your care and treatment moving into 2026 and 2027.

Source: Hemophilia Federation of American, September 2025. Read HFA’s complete State of the States policy & advocacy newsletter

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