CMS approved new state Medicaid waivers imposing work requirements and premiums — conditioning health coverage on employment as Project 2025's HHS chapter recommended.

Enhanced ACA premium tax credits expired, raising average benchmark silver plan premiums 18% nationally and affecting 21 million enrollees.

GAO finds Medicaid work-requirement demonstrations impose substantial administrative costs, with federal funds covering the majority of compliance verification spending.

CMS approved additional state Medicaid waivers imposing work requirements and premiums — conditioning health coverage on employment in low-wage labor markets.