Health Care

Work requirement deadlines strain state capability

States face challenges in implementing the programs for the first time.
Center for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, center, talks after a policy luncheon on Capitol Hill, Tuesday, June. 17, 2025, in Washington. (AP Photo/Mariam Zuhaib)

Editor’s note: This is the third story in a series on how the One Big Beautiful Bill Act and Congress are impacting states in new legislative sessions. Tune in throughout the week as we dive deep on health, tax and benefit policy.

New federally mandated Medicaid work requirements are posing a major test for nearly every state, where policymakers with limited resources have less than a year to figure out how to track whether tens of millions of low-income adults are complying. 

North Carolina lawmakers recently became among the first to publicly acknowledge that meeting a Jan. 1, 2027, deadline could be difficult.

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