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Understanding how health advocates, legislators are wrestling with Medicaid work requirements

Republican-controlled states are taking a fresh look at the subsidized expansion of Medicaid under the Affordable Care Act following a major shift in the federal government’s stance on 1115 demonstration waivers.

The Department of Health and Human Services’ recent green light for work requirements, drug tests, premiums and other policies rejected by previous administrations is attracting the interest of states that already expanded Medicaid and are now looking to tighten restrictions on the program, as well as states that never expanded Medicaid in the first place.

But for states looking to implement the newly-allowed restrictions, many difficult questions lie ahead.  Here’s a guide to understanding some of the economic and ideological battles playing out in the states.

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