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Montanans Could Face Medicaid Work Requirements, Higher Costs Earlier than Rest of Country
States face high administrative costs and complex technology challenges to verify that millions of Medicaid enrollees meet new work, volunteer, or school attendance requirements.
On July 4, President Donald Trump signed a law requiring 40 Medicaid expansion states and Washington, D.C., to verify enrollees' work or school status twice yearly.
Previously, oversight gaps emerged when the U.S. Government Accountability Office in 2019 examined five states’ Medicaid demonstration projects testing work tracking, which were rescinded under the Biden administration, with little federal oversight of costs.
New York projects it could cost $500 million in fiscal year 2026 to implement work requirements, potentially causing 600,000 to 1.1 million Medicaid enrollees to lose coverage.
North Carolina officials warn that an estimated 255,000 people could lose Medicaid coverage due to administrative burdens, according to Hannah Jones.
Experts predict a year and a half to comply may be insufficient, as stakeholders warn simple technology like a phone app could struggle to streamline reporting, Dr. Benjamin Sommers said.