States Rush To Figure Out How To Enforce Trump’s Medicaid Work Requirements
A KFF survey of state Medicaid officials offers insight into lingering uncertainty and differing plans for work requirement implementation as the Jan. 1 deadline approaches.
State Watch
A KFF Health News examination of how the Trump administration is reshaping health care in America.
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Trump’s Medicaid Work Mandate Debuting in Nebraska to Much Dismay
On May 1, the state will become the first to require people on the government health program to fulfill a work requirement or lose their coverage under a new rule that was a key part of congressional Republicans’ One Big Beautiful Bill Act.
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California Lawmakers Seek Protections for Patients in ICE Custody
Moving through the California Senate are two bills, informed by KFF Health News reporting, that would strengthen protections for patients brought to health facilities by Immigration and Customs Enforcement.
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Montana Moves Ahead With Doula Pay but Warns Medicaid Cuts Still May Come
Montana health officials say they’re seeking to add doula services to the state’s Medicaid program, reversing a previous statement that they would “not be moving forward” amid a budget shortfall.
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Real Estate Investors Profit From Long-Term Care While Residents Languish
Real estate investment trusts are landlords for thousands of nursing homes, assisted living facilities, and hospitals. Some select the managers and keep close watch over their performance but deny responsibility for bad care.
By Jordan Rau -
In Connecticut, Doctors Now Sue Patients Most Over Medical Bills, Surpassing Hospitals
Physicians, dentists, and other nonhospital providers account for more than 80% of health care debt collection cases in Connecticut courts, a CT Mirror-KFF Health News investigation finds.
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States Update Guardianship Laws To Keep Children of Immigrants Out of Foster Care
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New Federal Medicaid Rules Require One Month of Work. Some States Demand More.
Starting next year, about 18.5 million adults will be subject to new Medicaid work rules in 42 states and Washington, D.C. Applicants must show they’ve been working for at least a month before receiving benefits. Some Republican-controlled states want to triple the required work period.
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Medi-Cal Immigrant Enrollment Is Dropping. Researchers Point to Trump’s Policies.
A KFF Health News analysis found Medi-Cal lost almost 100,000 immigrants without legal status in the second half of 2025. California officials say it’s not clear if immigrants are losing coverage faster than other populations, but researchers said the most obvious driver is fear of the Trump administration’s immigration policies.
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Rural Nebraska Dialysis Unit Closes Despite the State’s $219M in Rural Health Funding
A rural Nebraska dialysis unit that was hemorrhaging money closed, upending patients’ lives. That’s despite a federal rural health program that granted the state more than $200 million this year to improve health care in rural communities.
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States Change Custody Laws To Keep Children of Detained Immigrants Out of Foster Care
As President Donald Trump’s heightened immigration enforcement continues across the country, some states are updating temporary guardianship laws to keep the children of detained and deported immigrants out of state custody.
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Pennsylvania Town Faces Fallout From Trump’s Environmental Rule Rollback
Even as the Trump administration publicly embraces the Make America Healthy Again movement and its ideals about reducing corporate harm to the environment, it has taken steps to stall environmental protections that MAHA followers hold dear.
By Stephanie Armour and Maia Rosenfeld -
States Face Another Challenge With Medicaid Work Rules: Staffing Shortages
Some states already don’t have enough staff to quickly process Medicaid applications and answer enrollees’ phone calls. Researchers say they may not be prepared to handle new Medicaid work rules, predicting people will lose coverage as a result.
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Urgent Care Clinics Move To Fill Abortion Care Gaps in Rural Areas
When the only clinic that offered abortions in Michigan’s rural Upper Peninsula closed, an urgent care facility stepped in to fill the gap. Now, others are considering similar moves as brick-and-mortar clinics close in blue states.
By Kate Wells -
This Northern Cheyenne Doula Was About To Start Getting Paid — Then Medicaid Cuts Hit
Montana was on track to start reimbursing doulas, who support new and expectant parents, through Medicaid this year. But state officials halted that plan amid a budget shortfall. Other such services deemed optional under Medicaid are at risk nationwide as states brace for federal cuts.
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State-Run Insurance Plans for Foster Kids Leave Some of Them Without Doctors
North Carolina rolled out a $3.1 billion insurance plan for kids in foster care, but many doctors did not accept patients on the plan. The state is one of several experimenting with a model that has left kids’ guardians scrambling to find health care providers.
By Andrew Jones -
After Man’s Death Following Insurance Denials, West Virginia Tackles Prior Authorization
After Eric Tennant died, his widow vowed to speak out against West Virginia’s Public Employees Insurance Agency, which had denied cancer treatment recommended by Tennant’s doctor. Her efforts paid off. In March, West Virginia’s governor signed a bill to protect some patients from harm tied to prior authorization.
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Trump’s One Big Beautiful Bill Act Darkens Outlook for Government-Backed Clinics
About 17,000 federally funded health clinics stand to collectively lose $32 billion under GOP-backed fiscal policies in the next five years — just as more uninsured patients will rely on them for low-cost care.
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Trump’s Hunt for Undocumented Medicaid Enrollees Yields Few Violators
Federal health officials have ordered states to reverify the immigration status of hundreds of thousands of Medicaid enrollees. After seven months, findings from five states show the reviews have uncovered few immigrants without legal status who are improperly receiving benefits.
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States Pay Deloitte, Others Millions To Comply With Trump Law To Cut Medicaid Rolls
The One Big Beautiful Bill Act will add red tape and restrictions for those seeking Medicaid and SNAP benefits. And the costs to update computer systems that determine eligibility for those programs will be steep.
By Samantha Liss and Rachana Pradhan