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work requirements
'Nebraska Is the Canary in the Coal Mine': Trump-GOP Medicaid Cuts Spark Mass Chaos, Coverage Loss
"Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," said one expert.
Oct 01, 2026
Human rights organizations said Thursday that Nebraska should be seen as a bright red warning sign of what's to come for states across the US as they implement the draconian Medicaid work requirements included in the budget legislation that President Donald Trump signed into law last year.
In early May, Nebraska became the first state to implement the new work reporting mandates, which require certain Medicaid recipients to document at least 80 hours of work or other qualifying activities per month to remain enrolled in the program. Republican Gov. Jim Pillen, announced the state's fast-tracked implementation of the requirements at a celebratory press conference late last year alongside Mehmet Oz, head of the Centers for Medicare and Medicaid Services.
Human Rights Watch (HRW), Oxfam America, and Nebraska Appleseed said in a joint report released Thursday that the rush to impose the mandates has had the predicted results of mass confusion and bureaucratic chaos, previewing what millions of Medicaid recipients across the country can expect in the months ahead.
“Nebraska is the canary in the coal mine for issues that most states will face when they begin implementing these work requirements,” said Matt McConnell, a US researcher on economic, social, and cultural rights at HRW. "As they do, they should make sure red tape doesn’t strip people of healthcare."
The trio of advocacy groups interviewed a dozen Nebraskans who have directly experienced or witnessed the unruly rollout of the expanded work requirements. One 64-year-old man "said he lost his Medicaid coverage while undergoing treatment for kidney cancer and multiple chronic health conditions," the groups noted.
"He said a representative of the health plan that managed his Medicaid coverage informed him he lost access because he was not working, even though he is unable to work due to his condition," the groups added. The man said the loss of Medicaid coverage disrupted his care, including an appointment with a cancer specialist.
The Trump administration has said even people with terminal cancer are not necessarily exempt from the new work reporting requirements.
One Medicaid eligibility worker from the Nebraska Department of Health and Human Services told HRW, Oxfam, and Nebraska Appleseed that "poor training, vague and inconsistent guidance, and technical issues, including unprepared software systems, had caused stress and uncertainty for applicants and for state employees."
“We just sometimes don’t know what we’re doing,” the worker said. "I wish the people who make policies knew what they were doing."
It's unclear exactly how many people have lost Medicaid in Nebraska as a result of the new requirements. Sarah Maresh, healthcare access program director at Nebraska Appleseed, said Thursday that obtaining data from the state has been "like pulling teeth."
"Nebraskans deserve access to this information," said Maresh. "You can’t fix problems you refuse to measure."
Earlier this week, following relentless pressure from advocates, Nebraska's health department released preliminary data showing that more than 1,000 Nebraskans have been deprived of Medicaid coverage due to the expanded work requirements—a figure that's believed to be a significant undercount.
"I have been saying for years that Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," Joan Alker, executive director of Georgetown University's Center for Children and Families, wrote in a blog post earlier this week. "Unfortunately, Nebraska’s data only reinforces this point."
Nationwide, millions of people have lost Medicaid coverage since Trump signed the GOP budget package, which includes around $800 billion in cuts to Medicaid over the next decade.
States face a January 1, 2027 deadline to implement the expanded work requirements—though states are allowed to move more quickly. Montana and Arkansas have joined Nebraska in implementing the mandates ahead of the federal deadline, resulting in similar chaos and confusion.
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Feeding the World, Through Policy and Community
Such an immense issue as food insecurity cannot be wholly solved by one channel or one institution alone; it takes policy advocacy, community organizing, and self-reliance moving hand-in-hand.
Sep 05, 2026
Bread for the World recently held its annual Advocacy Summit in Washington, DC. As a board member, I was honored to be part of conversations on how public policies affect people experiencing hunger and poverty. People from all walks of life and all backgrounds united with the common goal of developing institutions that advance food security.
This moment was especially full of policy discussions as midterm season is in full swing across the country. Leaders are itching to advance on the campaign trail. They are more likely to be on the ground listening to what we have to say, so the opportunity is ripe to share what we care about. We can ask them what they will do to reduce hunger and improve food security for those in poverty. We can push for accountability.
But first, we must understand the current policies and context today that create and maintain food apartheid.
As of the 2017 Census, Black farmers were reported to own just 0.32% of US farmland, a number which has been continuously decreasing over the past century. They are denied grants disproportionately to their white counterparts and earn approximately one-seventh of the income that their white counterparts bring in. Land ownership is steadily being stripped from us.
Hunger is not inevitable. It is possible to make change.
In the last year and a half, the Supplemental Nutrition Assistance Program (SNAP) has been on the chopping block many times. Since July of 2025, well over 3.5 million people have been pushed out of the program as a result of cuts in the federal budget. Newly enacted work requirements unjustly require people to qualify themselves to eat.
SNAP’s program for Women, Infants, and Children (WIC) is facing even further underfunding. Recent cuts will take away over $141 million in funds to feed over 5 million new mothers and young children—particularly funds designated for fresh fruits and vegetables. They are literally taking food out of the mouths of children.
This says nothing of the centuries of racism, blocked resources, and stolen land that brought us here today. It barely scratches the surface of all the factors influencing security today. We are facing hateful rhetoric; regressive social policies; global instability; and widespread threats to Black, brown, and immigrant communities. All this uncertainty makes us feel vulnerable. It makes food security and, indeed, any economic stability more tenuous.
There is no question that we need change; now is the moment to demand it from our leaders. Just as there are policies that harm access to nutritious food, there are certainly policies that can expand access.
We can remove work requirements for SNAP that pick and choose who gets to eat without regard for what they are going through. We can expand funding and access so that no one is left without nutritious food to sustain them. We can enact reparations to return land and opportunities to Black communities, and we can support the Black farmers and organizations working to feed people.
But, as we raise our voices for policy change, we must not overlook actions in our own neighborhoods.
I will always fight for a more representative government which supports the needs of our people. However, the government is still imperfect to say the least; we cannot wait for them while hunger runs rampant. We can take matters into our own hands.
Community organizing and self-reliance offers security especially when our government fails us; this is what we work for at The Black Church Food Security Network. We meet people where they are. We grow the food ourselves and distribute it throughout the community. We work together to build autonomy within our own communities.
Such an immense issue as food insecurity cannot be wholly solved by one channel or one institution alone. It takes policy advocacy, community organizing, and self-reliance moving hand-in-hand. Progress is possible when we approach it as a united front.
As Bread for the World reminded us through the advocacy summit, hunger is not inevitable. It is possible to make change. If we come together to uplift our communities and advance essential policies, we can create an environment where people are not only fed, but they are in a better position to feed themselves.
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RFK Jr. Dismisses Impact of SNAP Cuts as Data Shows 5 Million People Have Lost Aid
Robert F. Kennedy Jr., the head of the US Health and Human Services Department, said he doesn't think the Republican Party's unprecedented cuts to food aid would have "that much effect."
Aug 27, 2026
US Health and Human Services Secretary Robert F. Kennedy Jr. on Wednesday dismissed the impact of massive food aid cuts signed into law last summer by President Donald Trump, saying he doesn't believe the cuts will have "that much effect" as new data showed at least 5 million people have lost assistance so far—including roughly 1.5 million children.
Speaking at a news conference on children's nutrition in Florida, Kennedy falsely claimed that "the only people kicked off of" the Supplemental Nutrition Assistance Program (SNAP) under the GOP budget law signed by Trump "were people who were not eligible for it," either "because their income is too high or because they were illegal aliens."
Kennedy's remarks came as a new analysis by the Center on Budget and Policy Priorities (CBPP) found that SNAP enrollment nationwide has fallen to a 17-year low following enactment of the Trump-GOP budget law, which will cut the program by around $190 billion over the next decade, enact stricter work reporting mandates, and require states to contribute a portion of benefit costs for the first time.
"'Not much effect?' Based on available data from 25 states, we estimate that well over 1.5 million kids nationwide have lost SNAP in the wake of the unprecedented cuts in the Republican reconciliation law," Katie Bergh, a policy analyst at CBPP, wrote in response to Kennedy's remarks. "Many of those kids and their families lost SNAP despite still being eligible."
Watch Kennedy's comments:
Q: “Are either of you concerned that the reduction in funding for SNAP and the reduction in eligibility for SNAP will reduce access to food for children and families?”
Sec. Kennedy: “I don't think it's gonna have that much effect.” pic.twitter.com/1h97NP6rcN
— BulwarkClips (@BulwarkClips) August 26, 2026
News reports, anecdotal accounts from impacted families, and expert assessments contradict Kennedy's insistence that only those who were no longer eligible for SNAP due to income or immigration status have lost benefits. An explosion of red tape due to the new work reporting requirements imposed by the Trump-GOP budget law has made it more difficult for eligible beneficiaries to continue receiving SNAP, forcing many to seek aid from food banks and take desperate measures—such as skipping meals and doses of medication—to make ends meet.
CBPP warned that the impacts of the cuts are likely to intensify once the budget law's provision shifting benefit costs to states takes full effect next year.
"The magnitude of the cost shift and the urgency surrounding error rates may incentivize states to take drastic measures to reduce their payment error rates quickly and cut program costs, even if it means delaying or improperly denying benefits to eligible people," the think tank said on Wednesday. "We’re likely seeing some of those initial effects in SNAP participation data."
A report published last month by a pair of food policy experts argued that the unprecedented assault on SNAP undercuts Kennedy's so-called "Make America Healthy Again" initiative, which purports to place nutrition "at the center of health."
“If we are serious about improving Americans’ health, we need policies that make healthy food more accessible, not less,” said Priya Fielding-Singh of George Washington University’s Global Food Institute. “Cutting off food assistance for millions of families undermines MAHA’s stated goals of improving diet quality and preventing chronic disease. Food security and public health go hand in hand.”
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'So It Begins': Trump's Medicaid Work Requirements—as Designed—Wreak Havoc and Pain
"Pregnant woman disenrolled by mistake. Long waits to get through to the call center for help. No clarity on the rules. Medicaid work reporting requirements don’t work."
Aug 03, 2026
A growing chorus of Democratic lawmakers, policy experts, and advocacy organizations is calling on the Trump administration to immediately rescind a rule imposing more strict work reporting requirements on Medicaid recipients, a demand that came as Nebraska began kicking people off the healthcare program for not complying with the new mandates.
Under the expanded requirements, which were established by a 2025 Republican budget package that President Donald Trump signed into law, certain Medicaid recipients must document at least 80 hours per month of work or another qualifying activity to continue receiving assistance. In a statement late last week, Families USA executive director Anthony Wright warned that "these new paperwork requirements will push patients off coverage—not because they aren’t working or not eligible, but because of bureaucratic burdens."
Wright noted that under new rules stemming from the 2025 GOP budget law, even people with terminal cancer and other serious illnesses aren't necessarily exempt from the work reporting requirements, which apply to people between the ages of 19 and 64 who don't have a disability and aren't pregnant, in states that expanded Medicaid under the Affordable Care Act.
"The requirement that a patient doesn’t just need to have cancer or another condition but must produce the equivalent of a doctor’s note with a finding that the conditions leave them unable to work," said Wright, "is nowhere in the underlying statute, and unworkable."
A pair of Democratic lawmakers, Sen. Ron Wyden (D-Ore.) and Rep. Frank Pallone Jr. (D-NJ), similarly warned in a letter late last week that the Trump administration's implementation of the new work requirements "transforms Medicaid from a healthcare program into a bureaucratic maze that will fail eligible Americans, by design."
"It will strip coverage from people not because they are not already working or refuse to work, but because they cannot navigate a complex web of forms, passwords, and deadlines," the lawmakers wrote. "Implementing ineffective, exclusionary work reporting requirements will create costly administrative barriers and deny Americans access to health care, resulting in poorer health, higher mortality, and reduced financial security."
Wyden and Pallone urged the Trump administration to withdraw what the lawmakers described as a "disenrollment scheme" as Nebraska became the first in the US to disenroll Medicaid recipients for failing to comply with the reporting mandates.
The advocacy group Nebraska Appleseed has warned that the work requirements could put 40,000 Nebraskans at risk of losing Medicaid coverage. The requirements took effect in Nebraska on May 1—eight months ahead of schedule—and the state began disenrolling people for purported noncompliance on August 1.
In a blog post published last week, Nebraska Appleseed observed that the three months between the start of the work requirements and the first round of disenrollments was marked by "mass confusion," with Medicaid recipients experiencing "long call center waits, inoperable language lines, understaffed and undertrained caseworkers, policy questions gone long-unanswered, and the lack of public state data."
Joan Alker, executive director of the Center for Children and Families at Georgetown University, pointed with alarm to local reporting about the early impacts of the work reporting mandates in Nebraska.
"So it begins," Alker wrote in a social media post on Monday. "Pregnant woman disenrolled by mistake. Long waits to get through to the call center for help. No clarity on the rules. Medicaid work reporting requirements don’t work."
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Trump Admin Argues Even Terminally Ill Patients Shouldn't Be Exempt From Medicaid Work Requirements
Under a new policy the administration is defending in court, low-income people with cancer, HIV, Parkinson's, and other life-threatening illnesses must prove they're too sick to work or risk losing their health insurance.
Jul 30, 2026
A federal judge on Thursday denied a request by more than two dozen Democratic states to halt a Trump administration policy announced last month that would require Medicaid recipients with terminal diseases to prove they are too sick to work in order to be exempt from new work requirements that go into effect this coming January.
While introducing over $1 trillion in tax cuts for the wealthiest 1% of Americans, last year's massive GOP tax and budget bill also imposed new 80-hour-per-month work requirements that states must implement for Medicaid expansion recipients, who receive government-subsidized insurance coverage at or below 138% of the poverty line.
The law specified that those who are “medically frail or otherwise have special medical needs” are excluded from the work requirement, and specifically listed people with a “serious or complex medical condition.” But it remained unclear what exact conditions met these criteria.
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) introduced a new rule stating that even if a person receives a terminal diagnosis for a disease like cancer, HIV/AIDS, or Parkinson's, that is still not enough for them to be exempt from the work requirements.
Beginning on January 1, 2028, it says they must also demonstrate to states that their condition “significantly impairs” their ability to meet the work requirement.
Democratic attorneys general in 25 states and the District of Columbia filed a preliminary injunction over the rule late last month, arguing that CMS had rewritten the law to introduce a vague and needlessly restrictive new hurdle that vulnerable people will face in obtaining desperately needed care.
“This is one of those cases where it’s really hard to overstate how dire the consequences could be,” North Carolina’s Democratic attorney general, Jeff Jackson, told Politico. “You’re going to have 50 states doing 50 different things, and we’re all going to have to create a whole new bureaucracy... You are talking about a lot more paperwork, more evaluations, more doctor visits, and a lot more work for doctors themselves.”
The Democratic AGs argued that implementation of the work requirements should be paused because they lacked the staff or capacity to meet the timeline set by CMS, which requires states to communicate to enrollees how they'll be affected by the changes by the end of August.
US District Judge Richard Stearns on Thursday denied their initial request to immediately halt the implementation of the requirements while the lawsuit proceeds, but also did not rule on the lawsuit's merits, which are scheduled to be decided before the requirements go into effect on January 1.
Several medical associations, including the American Medical Association, the American College of Physicians, and the American Academy of Pediatrics, have come out against the rule, arguing that it would have dire consequences for people who suffer from severe illness.
"One of the most significant factors in whether someone survives a cancer diagnosis is whether they have health insurance coverage," Lisa Lacasse, president of the American Cancer Society Cancer Action Network, explained in June.
"The new restrictions link the definition of medical frailty to a person’s ability to work," she continued. "This would mean cancer patients and survivors who are suffering from debilitating side effects of the disease or treatment would have to officially prove they can’t work, in a process that is likely to be difficult and take a long time."
The nonpartisan Congressional Budget Office has projected that over the coming decade, changes to healthcare policy introduced by Republicans would increase the number of uninsured Americans by about 11.8 million.
Around 5.7 million of them are projected to be Medicaid recipients who either do not meet the 80-hour work requirement or are otherwise eligible but tripped up by one of the newly imposed paperwork hurdles.
Taya Graham and Stephen Janis argued earlier this week in a piece for The Real News Network that eligible people losing coverage is not an unfortunate side effect of the law, but a goal of the Republicans who passed it, who sought a way to thin the ranks of those who qualify for Medicaid without having to take the politically unpopular step of actually clawing back benefits.
They wrote that what has happened to recipients of the Supplemental Nutrition Assistance Program (SNAP) illustrates how burdensome these new requirements may become.
As The New York Times reported earlier this month, in Arizona, 440,000 people have already been dropped from SNAP after it enacted a formidable regime of paperwork for low-income recipients to prove eligibility, including requiring some people with panhandling income to obtain documentation from donors who drop them a buck on the street.
"If this is what people receiving SNAP benefits have been subjected to," Graham and Janis wrote, "imagine what’s going to happen to people who will need to navigate the new [Medicaid] requirements while struggling with a debilitating or terminal illness."
Medical issues are a leading cause of bankruptcy in the US. According to one study, over 4 in 10 cancer patients over 50 had depleted all their assets within two years of diagnosis.
Melanie D’Arrigo, a campaigner for single-payer healthcare in New York, said that President Donald Trump "cut cancer research, cut healthcare,” and with new Medicaid restrictions, “wants to make sure Americans continue to work as they go broke battling cancer.”
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Pediatricians Warn Trump Attack on Medicaid 'Will Harm Children's Long-Term Health'
"Efforts to undercut or undermine Medicaid for the children who rely on it are a bet against the future of the country," said the president of the American Academy of Pediatrics.
Jun 04, 2026
The American Academy of Pediatrics warned Wednesday that the Trump administration's new rule governing Medicaid work requirements will damage the health of children across the US, as additional bureaucratic barriers make it more difficult for families to access and maintain coverage.
AAP, the largest professional association of pediatricians in the country, said it "strongly opposes" the rule unveiled by the Centers for Medicare and Medicaid Services (CMS) earlier this week, calling it "an intentional policy choice that will harm children’s long-term health and well-being." The group said the rule should be rescinded.
“When parents have healthcare coverage, their children are more likely to be covered and stay covered over time, allowing uninterrupted access to the care they need to grow up healthy," said Andrew Racine, AAP's president. "Work requirements have not been shown to help adults gain employment. Instead, the added red tape makes it more difficult for eligible people to stay enrolled in Medicaid and makes the program less efficient overall. These administrative barriers will disproportionately hurt people with disabilities, and parents of children with special healthcare needs will lose coverage."
"The new burdensome requirements that many parents will face under this rule will ultimately undermine families’ health and financial stability," Racine added. "The policies to narrowly define who qualifies for exemptions will add to the state costs to administer the program, create headaches for families trying to navigate the bureaucracy, and harm the very people that Medicaid is meant to serve. Medicaid is a program designed around the needs of children. Efforts to undercut or undermine Medicaid for the children who rely on it are a bet against the future of the country."
Analysts and advocacy groups have said the Trump administration's rule, which implements work requirements included in a Republican budget law enacted last summer, will likely push millions of people off Medicaid—including many who are eligible but fail to comply with complex new reporting procedures.
The Center on Budget and Policy Priorities (CBPP) noted in Wednesday analysis that state agencies "will have to significantly re-work policy and systems" in light of the new rule, likely resulting in "errors and delays that could affect health coverage and care for the entire Medicaid population—including groups to whom the work requirement doesn’t apply, such as children, seniors, and people with disabilities."
Nearly half of all children in the US are enrolled in Medicaid or the Children's Health Insurance Program (CHIP). A recent analysis by the Center for Children and Families at Georgetown University found that two million fewer children were enrolled in Medicaid in April compared to the start of President Donald Trump's second White House term—and the number of uninsured kids is expected to grow as the GOP budget law's unprecedented Medicaid cuts take hold.
In addition to its impacts on children, critics say the new CMS rule will harm people with serious illnesses such as cancer and HIV/AIDS. The rule does not necessarily exempt such people from the Medicaid work mandates, which require certain program enrollees to document at least 80 hours per week of employment or related activities. The requirement is set to take effect nationwide in January 2027.
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement earlier this week that the Trump administration's new rule appears to run afoul of the law.
"People who have special medical needs, including those with a serious or complex medical condition, are statutorily exempt from the community engagement requirement," said Schmid. "People living with HIV have a lifelong serious and complex medical condition and have special medical needs—they cannot stay healthy without continuous access to lifesaving HIV treatment. Any gap will put them at risk of serious health consequences."
"We are disappointed that the Trump administration ignored the law and, while they agree that HIV/AIDS and viral hepatitis are serious or complex medical conditions, they are proposing that states will have to determine for every individual if their health is impaired and that they can’t comply with the work requirement," Schmid continued. "This added requirement was not in the law and puts the health of people living with HIV and viral hepatitis at risk."
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Trump's New Medicaid Rule 'Designed to Ensure People Lose Healthcare,' Critics Warn
"Today’s announcement marks a grim step in America’s march towards a healthcare system that further restricts access to healthcare and creates barriers rather than delivering affordable healthcare to families."
Jun 02, 2026
The Trump administration on Monday unveiled a rule that is expected to push millions of low-income people off Medicaid by imposing complex bureaucratic barriers in the form of work reporting requirements, which have proven disastrous at the state level.
The rule, released by the Centers for Medicare and Medicaid Services (CMS), marks a key step toward enacting the Republican budget reconciliation package that President Donald Trump signed into law last summer. That measure included around $900 billion in cuts to Medicaid, with new work requirements projected to account for nearly $330 billion of that total.
The new rule will dictate how states must implement the budget law's Medicaid work mandates and who is exempt from the requirements. States are already spending tens of millions of dollars hiring new staff and upgrading technology in preparation for the mandates taking effect next year.
Broadly, the Trump-GOP law requires adults without disabilities between the ages of 19 and 64 to demonstrate at least 80 hours of work, community service, or other "qualifying activities" per month to keep their Medicaid coverage.
Exemptions to the work reporting requirements include people who are pregnant, caregivers to children under the age of 14, or "medically frail." The CMS rule defines the latter category as those with "physical or behavioral health conditions that significantly impair their ability to consistently work or participate in other community engagement activities."
Advocates warned that the rule will force many sick people off coverage. The rule states that people with HIV/AIDS, end-stage renal disease, and cancer would not necessarily be exempt from the work reporting requirements.
According to The New York Times, "states had expected that people with certain serious diagnoses would qualify for the exception, and they had been developing ways to match applications with existing medical records to identify most such people automatically."
"Nebraska’s Medicaid program, which began enforcing a work requirement last month, developed a list of exempted conditions that is nearly 300 pages long," the Times reported. "The state will now need to adjust."
"When these requirements go into effect at the beginning of next year, it’s going to be a complete train wreck for America."
Anthony Wright, executive director of Families USA, said Monday that "far from protecting the vulnerable, this guidance significantly raises the barrier for demonstrating medical frailty, meaning many patients in the middle of treatment will have the new hassle of proving their condition, over and over, with any mistake or gap being penalized by the loss of their healthcare and coverage."
"Through this rule," said Wright, "CMS is requiring duplicative documentation and prohibiting states from taking full advantage of consumer-friendly tools like self-attestation."
During the first year of the work reporting requirements, which are set to take effect nationwide in January 2027, people will be allowed to attest in Medicaid applications that they meet one of the exemptions, according to administration officials.
"Beginning in 2028, states will be expected to verify the exemptions," NBC News reported. "The temporary flexibility, the officials said, is intended to give states time to build systems that can verify exemptions using claims data and other records."
The advocacy group Protect Our Care warned that the new rule "creates a labyrinth of paperwork, reporting mandates, and rigid eligibility rules designed to ensure people lose healthcare, even when they should qualify to keep it."
“Instead of lowering costs or making care more accessible, Republicans are weaponizing government bureaucracy against the American people," said Brad Woodhouse, the president of Protect Our Care. "They are betting that if they make the process confusing and exhausting enough, millions of people will fall through the cracks and lose the care they depend on to survive. Hospitals will suffer, providers will be pushed further to the brink, and families across the country will pay the price while Republicans once again put wealthy donors and corporate greed ahead of the health and well-being of everyday Americans.”
The nonpartisan Congressional Budget Office has projected that, over the next decade, the Trump-GOP work reporting requirements will push nearly 3 million people off Medicaid.
Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said in a statement that the CMS rule "is the dark heart of the Republican plan to kick millions of working Americans and their children off their health insurance by placing a mountain of paperwork in front of them."
"These barriers are designed to prevent Americans from getting affordable healthcare, while providing a profit bonanza for the corporate consultants who get paid millions to build bureaucratic booby traps," Wyden added. "The Republican plan for healthcare is to kick people when they are down, making sick people sicker and hard times even harder. When these requirements go into effect at the beginning of next year, it’s going to be a complete train wreck for America, and not just for the Americans caught in the bureaucratic maze Republicans have created: Every community will be left with worse healthcare."
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Rights Groups Warn of Disaster as Trump-GOP Work Requirements Risk Mass Medicaid Loss
“These work requirements address a problem that doesn’t exist," said one researcher. "They just strip healthcare from millions of low-income people by making it harder for them to prove they qualify.”
May 26, 2026
A pair of leading humanitarian groups warned Tuesday that millions of people will soon be "at risk of an avoidable loss of healthcare coverage" as states move to implement new Medicaid work requirements, which were at the center of the reconciliation package enacted by congressional Republicans and President Donald Trump last year.
Oxfam America and Human Rights Watch (HRW) warned in a joint letter to top federal health officials that the work requirements—which mostly target adults in states that expanded Medicaid under the Affordable Care Act—will result in a massive surge in the uninsured population if concrete steps aren't taken to mitigate coverage losses.
The groups point to a Congressional Budget Office analysis projecting the Trump-GOP budget law "will cause roughly 10 million people to lose health insurance coverage by 2034," increasing "the number of uninsured people in the US by nearly 50%, exposing millions of people to high drug and hospital costs, and forcing many to forgo or ration healthcare."
Under the 2025 law, people subject to the work requirements must document 80 hours per month of work or another qualifying activity.
"Work requirements are sold as sensible, pragmatic reforms, but the lived reality couldn’t be more different."
Analysts have warned that the new work reporting mandates—which account for around $326 billion of the Trump-GOP law's total cuts to Medicaid—will create massive administrative hurdles and burdens for Medicaid recipients and for states. Given that most Medicaid recipients already work, experts say coverage loss from the new mandates will largely be attributable to enrollees' failure to comply with byzantine reporting procedures.
“Work requirements are sold as sensible, pragmatic reforms, but the lived reality couldn’t be more different,” said Jackson Gandour, senior policy advisor for economic justice at Oxfam America. “In practice, evidence shows they can create unfair and effectively insurmountable barriers for people who need coverage and are making every effort to meet the requirements.”
The federal work requirements are set to formally take effect in most states by January 2027—though some states are rushing forward with the mandates ahead of schedule, heightening fears of chaos and large-scale coverage loss. By June 1, federal agencies must issue guidance to states on how to implement the new Medicaid work requirements.
Oxfam and HRW urged the Trump administration to do all it can to mitigate coverage loss, including by "reducing documentation requirements, broadly interpreting exemptions, and recognizing a wide range of qualifying activities that reflect real labor conditions, including gig work, unpaid caregiving, and seasonal employment."
A 36-year-old woman in Atlanta, Georgia—which has state-level work requirements that predate the Trump-GOP mandates—told the humanitarian groups that she lost Medicaid and nutrition assistance after her child was born late last year, despite working sufficient hours to comply with Georgia's requirements.
“After I had the baby, my Medicaid and food stamps were turned off,” she said. “[They] said that I failed to report that I was working."
The woman said she's spent months trying to restore her coverage, encountering chaos and administrative barriers.
“It’s hectic,” she said. “You’re not able to reach anybody.”
The Urban Institute has estimated that even if strong mitigation measures are put in place, around 3 million people could lose Medicaid coverage due to the new federal work requirements.
“These work requirements address a problem that doesn’t exist since most Medicaid recipients are already working,” said Matt McConnell, economic justice and rights researcher at Human Rights Watch. “They won’t fix the budget. They just strip healthcare from millions of low-income people by making it harder for them to prove they qualify.”
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'Disgusting': Republicans Applaud as Trump Brags About Taking Food Aid From Millions
"His Big Ugly Bill ripped food away from hungry moms, kids, and seniors to fund tax cuts for the wealthiest Americans," said one House Democrat.
Feb 25, 2026
US President Donald Trump received a standing ovation from Republican lawmakers and administration officials Tuesday night when he bragged during his State of the Union address about taking nutrition assistance from millions, which he euphemistically characterized as lifting people off food stamps.
"In one year, we have lifted 2.4 million Americans—a record—off of food stamps," Trump said during his nearly two-hour speech.
The Republican reconciliation package that Trump signed into law last summer included $187 billion in cuts to the Supplemental Nutrition Assistance Program (SNAP) over a 10-year period, the largest cuts to the program in US history.
Trump: "In one year, we have lifted 2.4 million Americans -- a record -- off of food stamps" (In other words, Republicans cut food stamps) pic.twitter.com/19EoNEUmPF
— Aaron Rupar (@atrupar) February 25, 2026
The Republican law includes reductions in federal nutrition funding for states—which administer SNAP—as well as expanded work requirements, which the nonpartisan Congressional Budget Office estimated would strip nutrition benefits from "roughly 2.4 million people in an average month" over the next decade.
As the Center on Budget and Policy Priorities noted in a recent analysis, changes enacted by the Trump-GOP law mean that "for the first time in the 50-year history of the modern SNAP program, the federal government will no longer ensure that the lowest-income people, including children, older adults, veterans, and people with disabilities, in every state have access to the food assistance they need because states that refuse to pay the cost share could see the program end."
Shortly after Trump signed the Republican megabill into law, his administration canceled an annual US Department of Agriculture survey aimed at measuring food insecurity, undercutting efforts to track the impact of the unprecedented SNAP cuts. The USDA's final reports estimated that nearly 48 million people in the US faced food insecurity in 2024—including nearly one in five households with children.
"Trump says he 'lifted' millions off food stamps," Rep. Brittany Pettersen (D-Colo.) wrote in response to the president's State of the Union remarks. "But what he really means is his Big Ugly Bill ripped food away from hungry moms, kids, and seniors to fund tax cuts for the wealthiest Americans. The lies are blatant and disgusting."
Rep. Sarah McBride (D-Del.) denounced her Republican colleagues for their celebratory response to Trump's boast.
"They're applauding ripping food out of people’s mouths to fund their tax cuts for billionaires," McBride wrote on social media.
USDA data released ahead of Trump's speech shows that around 696,000 fewer people received SNAP benefits in November 2025 compared to the previous month.
Katie Bergh, a senior policy analyst on the food assistance team at the Center on Budget and Policy Priorities, noted that "people haven’t been dropping off SNAP because they no longer need help."
"Economic conditions haven’t improved and groceries haven’t gotten more affordable," Bergh added. "They're losing basic food assistance because of policy choices. Allowing this trend to continue is also a policy choice."
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The Shutdown Is Over, But America's Hunger Crisis Isn't
As the government reopens, millions will still lose access to food assistance starting almost immediately due to policy changes in the GOP's "Big Beautiful Bill."
Nov 17, 2025
The roughly 42 million Americans who rely on food stamps did not receive their November 1 Supplemental Nutrition Assistance Program benefits as the government shutdown dragged on. The missed payments came just as the holiday season began, leaving many families struggling to put food on the table. Lines at food banks backed up traffic across the country.
The Trump administration defied federal court orders to restore full funding to the program before the Supreme Court’s conservative majority temporarily green-lit the freeze. The White House even tried to claw back funding from states that had already distributed it to hungry families.
Lawmakers have now negotiated an end to the shutdown. But the threat to the nation’s primary nutrition assistance program, SNAP, is far from over. As the government reopens, millions will still lose access to food assistance starting almost immediately.
The GOP’s “Big Beautiful Bill,” passed earlier this year, guts core safety net programs to fund tax cuts for billionaires, mass deportation efforts, and bloated military spending. The GOP law includes the largest SNAP cuts in history, slashing our most important and effective anti-hunger program by roughly 20%.
We have the tools to fight hunger, and we must use them.
People in every state are at risk of losing their food benefits, according to the Center on Budget and Policy Priorities. One of the main ways the bill cuts SNAP is by expanding harsh and ineffective work requirements. These new rules will strip food assistance from millions of people, including children, seniors, veterans, and individuals with disabilities. According to the Congressional Budget Office, the change will cause 2.4 million people to lose benefits in an average month.
Those rules are now in effect, just as families prepare to celebrate Thanksgiving and the winter holidays.
Research shows such requirements have little effect on employment: Most working-age adults enrolled in these programs are already working, and those who are not employed often face high barriers such as caregiving responsibilities or health conditions. Instead, these requirements cause many people who should qualify for SNAP to lose benefits due to red tape and administrative error.
The GOP law also shifts SNAP costs onto states for the first time in the program’s history. This vital food program has always been fully federally funded, but the new budget will require states to take on a significant share of expenses. The unprecedented burden shift will likely lead many states to cut enrollees or even terminate food aid programs entirely for the first time since their inception, causing even more people to go hungry.
As the government resumes normal operations, the fight against hunger must continue. SNAP has long proven to be highly effective at reducing food insecurity and hunger, especially among children. We have the tools to fight hunger, and we must use them.
In the richest country in the world, no one should go hungry.
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