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New Medicaid work requirements are coming. Here’s what you need to know. 

2 August 2026 at 11:00
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The Wisconsin Department of Health Services is preparing to implement new federal Medicaid work requirements that could put health insurance coverage at risk for tens of thousands of BadgerCare Plus members.

Department of Health Services Secretary Kirsten Johnson and Wisconsin Medicaid Director Amanda Dreyer answered reporters’ questions Thursday about how the state plans to implement the new requirements and what members should do now.

Here’s what you need to know.

Who is impacted

The new requirements were created under the One Big Beautiful Bill Act, which requires states to implement Medicaid work requirements for some adults.

In Wisconsin, the requirements apply to BadgerCare Plus members ages 19 to 64 who do not have a dependent child younger than 19 living with them.

About 200,000 Wisconsin adults will be subject to the new requirements. The agency estimates about 63,000 people are at immediate risk of losing their health care coverage because the state does not currently have documentation showing they meet the requirements or qualify for an exemption.

New requirements

To keep Medicaid coverage, affected members must show they completed at least 80 hours of employment, volunteer work, school, job training or another qualifying activity in a single month during the 12-month period since they were last approved for health care coverage.

Some people may qualify for exemptions, including those who are medically frail or family caregivers, but Department of Health Services leaders say they are waiting for federal guidance on what documentation will be required. 

Work requirements will take effect for new Medicaid applicants early next year. Starting in January 2027, new applicants must meet the federal work requirement in the month before they apply.

Current BadgerCare Plus members will be subject to the requirements when they renew their coverage starting in March 2027.

What you can do

State officials say the most important step is making sure the department has current contact information.

Medicaid members should keep their mailing address, phone number and email address up to date to ensure they receive important notices about the upcoming changes. Members can update their information through the ACCESS Wisconsin website or the ACCESS smartphone app.

The department also recommends keeping documentation such as pay stubs, volunteer records or school enrollment information that may be needed during the renewal process.

Where possible, the Department of Health Services plans to use existing medical records and diagnosis codes to identify people who qualify for exemptions rather than requiring new paperwork. During the program’s first year, members who believe they are medically frail may self-attest while the department obtains supporting documentation.

Resident outreach

The Department of Health Services is working with health care providers, counties and community organizations to prepare for the changes, with a particular focus on helping people experiencing homelessness and others who may have difficulty meeting the new reporting requirements. 

The department has also created a “Medicaid: New Federal Work Requirement” webpage that it will update with new information about eligibility, exemptions, reporting requirements and implementation timelines.

Johnson said the state’s goal is to ensure everyone who qualifies for Medicaid can keep their coverage despite the new federal requirements.

Department of Health Services leaders estimate the first year of implementation will cost about $10 million in system upgrades. The agency is still finalizing staffing and training costs. Officials say they will continue working with local partners to help members understand the new rules and avoid unnecessary loss of health coverage.

Jonathan Aguilar is a visual journalist at Milwaukee Neighborhood News Service who is supported through a partnership between CatchLight Local and Report for America.

New Medicaid work requirements are coming. Here’s what you need to know.  is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Wisconsin governments have received $160 million in opioid settlement funds. Here’s where it’s going.

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  • Just eight local governments had spent more than half of their opioid settlement funds by the end of 2025, while 16 hadn’t spent any.
  • Even with millions still available and more payments on the way, local officials are already worried about what happens when the money runs out.
  • At least 17 local governments used some settlement dollars to support law enforcement.
  • About a dozen counties are using funds for foster care or services aimed at preventing family separations.
  • A dozen local governments identified transportation as a major barrier to accessing opioid-related services.
  • Local governments reported spending more than $2 million on treatment for incarcerated people.

Local Wisconsin governments have received more than $160 million in settlement payments from drug makers, distributors and pharmacies that were sued for their role in the country’s opioid epidemic.

Wisconsin and 87 local governments are expected to receive more than $874 million by 2038, up from projections Wisconsin Watch reported in 2025. 

The Wisconsin Department of Health Services gets 30% of the state’s settlement payments and documents its spending online while updating the Legislature quarterly. 

The rest flows to 71 Wisconsin counties (all but Polk, whose board declined to join Wisconsin’s lawsuit) and 16 municipalities, which started receiving it in 2022. Each tracks and spends the funds a little differently. 

As Wisconsin Watch previously reported, it’s not always easy to follow the money. But all local governments must provide the Legislature and the Wisconsin Department of Justice annual reports that include basic accounting. Many also answer optional questions from the Wisconsin Counties Association.

Wisconsin Watch created a database with the most recently reported local government settlement spending information. Here are some trends and notable findings:

  1. Money stayed in the bank. Just eight local governments had spent more than half of their opioid settlement funds by the end of 2025, while 16 hadn’t spent any.
  1. Officials wonder: What happens after the money runs out? Even with millions still available and more payments on the way, local officials are already worried about what happens when the money runs out. Several local governments said the eventual end of disbursements could put staff positions and programs in jeopardy.
  1. At least 17 local governments used some settlement dollars to support law enforcement. Multiple counties and municipalities hired specially trained co-responders who accompany officers on calls involving mental health or substance use issues. Other governments bought surveillance cameras, drug-checking equipment or vehicles or hired drug task force investigators.
  1. Funds flowed to foster care. Counties oversee foster care and have long cited parental substance use as a driver of family separation. About a dozen counties are using funds for foster care or services aimed at preventing family separations.
  1. Transportation barriers. A dozen local governments identified transportation as a major barrier to accessing opioid-related services. Several counties used settlement dollars last year to help residents travel to treatment and other services.
  1. Prevention prevails. The Wisconsin Counties Association asked local governments to break their settlement spending into 10 categories. Counties reported spending the most, nearly $6 million, on prevention — defined as efforts to prevent opioid use disorder and to screen for the condition. More than a dozen local governments funded school-based prevention programs, including youth peer support and DARE. 
  1. Counties spend on jail treatment. People leaving jails and prisons face a high risk of  overdose. Local governments reported spending more than $2 million on treatment for incarcerated people. The number of county jails providing medications for opioid use disorder doubled between 2021 and 2024, according to the Wisconsin Policy Forum. More than 20 governments described spending settlement dollars for jail-based programming, including several that provided medications for opioid use disorder. 
  1. Early signs of progress. Many local governments cited plunging overdose rates as  success. Statewide overdoses fell by more than 42% between 2023 and 2024. More work is needed, multiple officials acknowledged, considering that opioid overdoses remain far  higher than a decade ago. Still, they see expanded access to opioid reversal medications and treatment services as something to celebrate. 

What stands out to you? Explore the database and tell us what you notice or want us to investigate — or if you have any questions. Submit a tip or email editor@wisconsinwatch.org.

Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.

Wisconsin governments have received $160 million in opioid settlement funds. Here’s where it’s going. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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