Trump administration lets states delay cutting Medicaid coverage under new work requirement

Pennsylvania and other states will be allowed to wait until July before removing people from Medicaid for failing to meet a new federal work rule, the Trump administration said Friday, according to The Philadelphia Inquirer and the Pennsylvania Capital-Star.

The rule was included in the sweeping tax and domestic policy package Republicans passed in mid-2025 and was due to start Jan. 1. Under it, most enrollees must log 80 hours monthly of employment, community service or education to qualify or stay covered.

Dan Brillman, the federal official in charge of Medicaid, told state program directors in a letter that Washington still wants states to begin verifying enrollees' work status in January, the Inquirer reported in a story first published by The New York Times. But for half a year, states will not be obligated to terminate coverage for those who fall short.

"We have heard directly from states about their implementation timelines, impediments to successful launches at scale," Brillman wrote, according to the Inquirer. The Capital-Star reported that the agency labeled the grace window an "optional hold harmless period" intended to let states upgrade their systems and procedures.

The Inquirer reported that states had faced costly work building software to monitor enrollees' jobs, and that hospitals had organized large campaigns to guide patients through the extra paperwork. The paper said the decision followed a court loss: a Massachusetts federal judge concluded the administration had set an overly strict standard, beyond what the law allows, for deciding which people count as "medically frail." That ruling had already given 25 states and the District of Columbia six months of relief from parts of enforcement.

Officials had previously said no delays were coming. Speaking to state officials last summer, Sara Vitolo, deputy director for Medicaid, acknowledged, "We know it's going to be really hard for you to meet the deadline," the Inquirer reported.

The Capital-Star reported that the rule covers enrollees ages 19 through 65. Exempt groups include pregnant people, those raising dependent children, people with complex health conditions, members of tribal communities, foster youth and some former foster youth, and people freed from jail or prison in the previous 90 days.

According to the Inquirer, the Congressional Budget Office projected that 5 million additional Americans would lose insurance in the coming years because of the policy. Nebraska and Montana started enforcing it early, and Nebraska officials believe over 1,700 residents have since lost or been refused coverage.

Democrats have objected. The Capital-Star reported that Rep. Frank Pallone Jr. of New Jersey and Sen. Ron Wyden of Oregon sent a letter this week asking the administration to grant states extra time. The Inquirer reported that House Democratic leader Hakeem Jeffries intends to hold a vote on repealing the requirement early in the next Congress.

Compiled by True News from reporting by The Philadelphia Inquirer and Pennsylvania Capital-Star. Each outlet's original story is linked below.

Originally published by True News: https://truenews.bagleyenterprises.net/stories/1065