Millions will lose Medicaid once new work rules kick in. These groups will be hit the hardest.

The Trump administration implemented work requirements for Medicaid enrollment in 2025, with the Centers for Medicare and Medicaid Services reporting an estimated reduction of approximately $1 trillion in federal Medicaid spending over 10 years. The policy requires non-elderly, non-disabled adults to document work or work-related activities to maintain coverage. States began implementing the requirements at varying dates throughout 2025 and into 2026.

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