Illustration: Tiffany Herring / Axios
Moving up the date for Medicaid work rules to begin could pose a major implementation challenge for states, GOP leaders acknowledge.
Why it matters: Speeding up the timeline would put budget and administrative pressures on states that have to verify that Medicaid recipients are fulfilling requirements to continue receiving benefits.
What they're saying: "It takes [states] some time, we've learned in this process, to change their systems and to make sure that these stringent requirements that we will put on … to eliminate fraud, waste and abuse, can actually be implemented," Speaker Mike Johnson said on "Fox News Sunday" when asked why the work requirements had been set for 2029.
- "We're working with them to make sure what the earliest possible date is to put into law something that will actually be useful," Johnson added.
- House Majority Leader Steve Scalise said on CNBC on Monday morning that the new date would be "early 2027" and that lawmakers had "worked with Dr. Oz" at CMS on the implementation issues.
Yes, but: Some experts have long warned that Medicaid work requirements are hard to implement without inadvertently kicking some working people off program rolls if they don't file the right forms or if they otherwise get caught up in red tape.
- "Implementing a mandatory work requirement would require states to set up entirely new systems for reporting work as well as for exemptions," Edwin Park, research professor at the Georgetown Center for Children and Families, wrote in an email.
- "These systems will have to be largely built from scratch and therefore will be both costly and complex," he added. "It is hard to see how states could have these systems up and running in a year and a half."
- He warned that the confusion could result in even higher levels of uninsured people.
