States Face Crunch to Implement Medicaid Work Requirement

Republican lawmakers’ success in enacting sweeping overhauls to Medicaid eligibility is prompting concern that states won’t have enough time to build the infrastructure required to support the changes.

The tax and spending package introduces some of the largest wholesale changes to the Medicaid program since the passage of the Affordable Care Act in 2010. Under the law, states will have to implement a rash of administrative changes, including the introduction of biannual eligibility redeterminations, mandatory copays, and restrictions on supplemental financing methods like provider taxes.

The spending bill leaves states through December 2026 to build the IT systems and ...