Don Moynihan (@donmoynihan): "In January of 2027, states will be required by Trump to implement work requirements in Medicaid. All prior evidence suggests this will be a disaster. Lots of eligible people will lose coverage because of the administrative burden, and it will not encourage labor force participat…"

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In January of 2027, states will be required by Trump to implement work requirements in Medicaid. All prior evidence suggests this will be a disaster. Lots of eligible people will lose coverage because of the administrative burden, and it will not encourage labor force participation.

The best engineering solution to mitigate coverage losses is to enable states to automate the renewal process. But the Trump administration is also making this harder. It is an administrative disaster by design.

The use of these automated processes has the potential to offset significant amounts of coverage loss associated with the new work requirements. But the Trump administration has already made it harder for states to automate renewals by rolling back a series of state administrative flexibilities. Between June and July of 2025 alone — when many policy flexibilities started to expire — ex parte renewals dropped by 6 percentage points.

Pamela Herd and Don Moynihan

Apr 10

4:29 PM

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