Tara covers the business of health care. Her stories focus on hospitals, doctors, and how their business practices affect patients — especially when private equity gets involved. She also writes about health insurance and ideas for improving our broken health system. You can reach Tara on Signal at tarabannow.70.WASHINGTON — The Trump administration on Monday published a highly anticipated document that lays out the rules for sweeping new requirements that many adult Medicaid beneficiaries work or attend school in order to qualify for coverage.

The rule, from the Centers for Medicare and Medicaid Services, establishes standards states must use to implement Medicaid work requirements, including who is exempt from the requirements, how to verify exemptions, and state reporting requirements. The work requirements, created as part of President Trump’s 2025 tax cut bill, are popular among Republican politicians, but generally opposed by Democrats and advocates for people who are seriously ill or have lower incomes.

According to initial estimates, the work requirement policy was expected to reduce federal Medicaid spending by $326 billion and cost 5.3 million people their Medicaid coverage. On Monday, a division of the federal Department of Health and Human Services published a research brief contending that the rules may push more people to work, reducing poverty by 1.6 million to 2.9 million people.