Projected Reductions in Medicaid Expansion Enrollment Under OBBBA’s Work Requirements and Six-Month Redeterminations

The One Big Beautiful Bill Act established new work requirements and increased the frequency of eligibility redeterminations for adults covered by ACA Medicaid expansion. In this report, Urban Institute researchers estimate coverage changes under three potential scenarios, in which states adopt policy and implementation choices involving high, medium, and low mitigation of coverage losses among eligible adults who are meeting work requirements or exempt.