Across the nation, states face an immense task and high costs for new Medicaid work and eligibility requirements.
A law signed last year by President Donald Trump will require some adult Medicaid participants to show they are working, volunteering, or taking classes. And they will face eligibility reviews every six months, instead of annually.
The work requirement applies only in states that have expanded Medicaid coverage to adults ages 19 through 64, without young children, whose incomes are above the typical eligibility cutoff. Georgia is the only state that already has a work requirement for some Medicaid recipients.
The requirement does not apply in eight states, including Kansas and Texas.
To carry out the new requirements, many states first will have to spend millions of dollars improving their computer systems.
Congress has provided $200 million to help states implement the new requirements. The first of that money already has begun flowing to states. But the tab for the needed technology improvements and additional staff is likely to exceed $1 billion, according to an Associated Press analysis of budget projections in more than 25 states. That extra cost will be borne by a mixture of federal and state tax dollars.