Health Care

Beyond the Big Beautiful Bill: How the Trump admin. is reshaping Medicaid

It is unclear how states will respond to new rules and guidance CMS issued in recent weeks.
President Donald Trump greets Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz after en event about TrumpRx in the South Court Auditorium in the Old Eisenhower Executive Office Building on the White House campus, Thursday, Feb. 5, 2026, in Washington. (AP Photo/Alex Brandon)

The Trump administration is leveraging obscure regulatory decisions to scale back the Medicaid program beyond the massive changes approved by Congress in the One Big Beautiful Bill Act.

New rules and guidance issued by the Centers for Medicare and Medicaid Services over recent weeks could: make it harder for enrollees to claim exemptions from new work requirements; reduce the amount of money states are allowed to direct to hospitals and other providers to supplement low reimbursement rates; and increase federal oversight of pilot programs that allow states to expand the reach of Medicaid benefits.

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