New work requirements for some Medicaid beneficiaries begin across the U.S. in January as a result of President Donald Trump’s major 2025 tax cut and policy law. At least six Republican-led states are imposing stricter rules than the law requires, demanding immediate medical documentation instead of accepting beneficiaries’ self-attestation. The Congressional Budget Office estimates these changes will save the federal government $887 billion over the next decade and result in 7.5 million fewer people with health insurance. Democrats in 25 states are suing, arguing the rules are too harsh. Patient advocates worry that qualified individuals will be denied aid because they cannot afford to see a doctor to obtain the required documentation.
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