06/01/2026
Montana is becoming an early test of Medicaid work requirements — and it's exposing a troubling reality.
State officials are being asked to build costly new systems, hire staff, and navigate complex eligibility rules while already facing budget shortfalls. Meanwhile, eligible people risk losing health coverage because of paperwork and reporting requirements.
More bureaucracy. More costs. More barriers to care.
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The state is ramping up to implement the federal work requirements six months ahead of the deadline. But Montana is one of several states already struggling to pay for health services.