Redetermination didn't end with the unwinding. It became the permanent operating condition.
Every 6 months
Beginning December 31, 2026, states must redetermine eligibility for Medicaid expansion adults twice a year, and verify work requirements at application and at renewal.
KFF, work requirement provisions of the 2025 federal budget reconciliation law
Up to 3.1M
2.0 to 3.1 million people are projected to lose coverage in 2028 from six-month redeterminations alone. The mechanism is procedural: missed notices, late responses, and documentation that doesn't arrive in time.
Robert Wood Johnson Foundation analysis, March 2026
−2.4%
Average operating margin for community health centers in 2024, down from 1.6% a year earlier, with a quarter of centers below negative 5%.
2024 UDS data · NACHC analysis, 2025