The changes are going to have a big impact on state governments. Figuring out how to handle them will be one priority for state lawmakers and governors as legislative sessions begin, many of them in January.
The 40 states that previously expanded Medicaid to cover a slightly higher-income group of adults will be required to implement work requirements for some beneficiaries by January 2027.
All states are going to have to pay a bigger share of the administrative costs for the Supplemental Nutrition Assistance Program, or SNAP, starting in October. And many could eventually be required to pay some benefit costs if their payment error rates are above 6%.
States also can decide whether to incorporate federal changes into their state income tax laws, including whether to eliminate taxes on overtime pay and tips.