In an informational bulletin released to states on December 8, 2025, the Centers for Medicare and Medicaid Services (CMS) explains, in plain language, various aspects of HR 1’s section 71119, which lays out the obligation of Medicaid expansion states to impose work reporting requirements (aka community engagement requirements) for eligibility in Medicaid via the expansion pathway. More here.

LeadingAge and various partner organizations on December 5, 2025 met with Center for Medicaid and CHIP Services (CMCS) staff on issues including the Medicaid Access Rule’s 80/20 requirement and HR 1’s community engagement requirement (aka work requirement). More here.

A “Dear Colleague” letter by the director of the Center for Medicaid and Chip Services within The Centers for Medicare and Medicaid Services (CMS) provides background on the agency’s thinking about how states must redesign multiple aspects of their Medicaid programs, including perspectives related to statutes governing Medicaid provider taxes. Even so, key questions remain unanswered. Read more here.

According to an analysis by research organization KFF, 31 of 51 Medicaid programs (including Washington, DC) will require changes to provider tax programs. Due to Centers for Medicare and Medicaid Services (CMS) guidance following the passage of HR 1, those 31 states had non-exempt provider taxes that exceed 3.5% of net patient revenues, requiring reductions in the funds the states can collect and attribute to their non-federal share of Medicaid funding. Read the details here.

Health policy research organization KFF, in a November 20, 2025 analysis of data it gathered as part of its 25th Annual Medicaid Budget Survey, shows that 44 of 50 states use limits on waiver enrollment, spending, or services to create budget predictability and curtail spending in home and community-based services (HCBS) programs. The data highlight the most likely policy levers for states to pull. Learn more.

A 37-page informational bulletin authored by Centers for Medicare and Medicaid Services (CMS) Deputy Director Dan Brillman, also the director for the Center for Medicaid and CHIP Services, summarizes provisions of HR 1 focused on Medicaid and the Children’s Health Insurance Program. More here.

States are grappling with tighter Medicaid budgets as enhanced COVID-19 funding ends and health care costs surge, according to KFF’s annual survey. Despite fiscal pressures, many states are expanding benefits, like coverage for GLP-1 drugs, while weighing austerity measures to preserve access. Get the full details here.

A new analysis from KFF projects $911 billion in federal Medicaid reductions over the next decade under HR 1, with expansion states accounting for more than half of the cuts. See which states face cuts approaching 20% and explore interactive charts and maps that break down the impact. Learn more.