Personal Finance

How work requirements may reduce access to Medicaid

Published

2 months ago

March 9, 2025

Protect Our Care supporters display “Hands Off Medicaid” message in front of the White House ahead of President Trump’s address to Congress on March 4 in Washington, D.C.

Paul Morigi | Getty Images Entertainment | Getty Images

Cuts to Medicaid will have to be on the menu if House Republicans want to meet their budget goals, the Congressional Budget Office said in a report this week.

The chamber’s budget blueprint includes $880 billion in spending cuts under the House Energy and Commerce Committee, which oversees the program.

Medicaid helps cover medical costs for people who have limited income and resources, as well as benefits not covered by Medicare such as nursing home care.

To curb Medicaid spending, experts say, lawmakers may choose to add work requirements. Doing so would make it so people have to meet certain thresholds, such as 80 hours of work per month, to qualify for Medicaid coverage.

Republicans have not yet suggested specific changes to Medicaid. However, a new KFF poll finds 6 in 10 Americans would support adding work requirements to the program.

Imposing work requirements may provide a portion of lawmakers’ targeted savings. In 2023, the Congressional Budget Office found implementing work requirements could save $109 billion over 10 years.

Yet that change could also put 36 million Medicaid enrollees at risk of losing their health-care coverage, estimates the Center on Budget and Policy Priorities. That represents about 44% of the approximately 80 million individuals who participate in the program. The estimates focus on adults ages 19 to 64, who would be most likely subject to a work requirement.

The idea of work requirements is not new. Lawmakers have proposed work hurdles to qualify for other safety net programs, including the Supplemental Nutrition Assistance Program, or SNAP.

The approach shows an ideological difference between the U.S. and European social democracies that accept a baseline responsibility to provide social safety nets, said Farah Khan, a fellow at Brookings Metro’s Center for Community Uplift.

“We view welfare as uniquely polarized based on which party comes into power,” Khan said.

When one party frames it as a moral failing to be poor because you haven’t worked hard enough, that ignores structural inequalities or systemic injustices that may have led individuals to those circumstances, she said.

Medicaid work requirements prompt coverage losses

Loss of coverage has been a common result in previous state attempts to add Medicare work requirements.

When Arkansas implemented a work requirement policy in 2018, around 1 in 4 people subject to the requirement, or around 18,000 people total, lost coverage in seven months before the program was stopped, according to the Center on Budget and Policy Priorities. When New Hampshire attempted to implement a work requirement policy with more flexible reporting requirements, 2 in 3 individuals were susceptible to being disenrolled after two months.

“Generally, Medicaid work requirements have resulted in coverage losses without incentivizing or increasing employment and are a policy that is really unnecessary and burdensome,” said Laura Harker, senior policy analyst at the Center on Budget and Policy Priorities.

The “administrative barriers and red tape” from work requirements broadly lead to coverage losses among both working individuals and those who are between jobs or exempt due to disabilities, illnesses or caretaking responsibilities, according to the Center on Budget and Policy Priorities.

Rep. Ro Khanna: Democrats oppose $2 trillion in Medicaid cuts and tax breaks for the wealthy

Notably, around 9 in 10 Medicaid enrollees are already working or qualify for an exemption, Harker said.

Separate research from the American Enterprise Institute finds that in a given month, the majority of working-age people receiving Medicaid who do not have children do not work enough to meet an 80-hour-per-month requirement.

Consequently, if work requirements are imposed on nondisabled, working-age Medicaid recipients, that would affect a large number of people who are not currently in compliance, said Kevin Corinth, deputy director at the Center on Opportunity and Social Mobility at the American Enterprise Institute.

Either those individuals would increase their work to remain eligible or they wouldn’t, and they would be dropped off the program, Corinth said.

“If you put on work requirements, you’re going to affect a lot of people, which could be good or bad, depending on what your view of work requirements are,” Corinth said.

Lawmakers may also cut Medicaid in other ways: capping the amount of federal funds provided to state Medicaid programs; limiting the amount of federal money per Medicaid recipient; reducing available health services or eliminating coverage for certain groups.

Personal Finance

Here are the HSA contribution limits for 2026

Published

18 hours ago

May 2, 2025

Business Finance News

Maskot | Maskot | Getty Images

The IRS on Thursday unveiled 2026 contribution limits for health savings accounts, or HSAs, which offer triple-tax benefits for medical expenses.

Starting in 2026, the new HSA contribution limit will be $4,400 for self-only health coverage, the IRS announced Thursday. That’s up from $4,300 in 2025, based on inflation adjustments.

Meanwhile, the new limit for savers with family coverage will jump to $8,750, up from $8,550 in 2025, according to the update.

To make HSA contributions in 2026, you must have an eligible high-deductible health insurance plan.

For 2026, the IRS defines a high deductible as at least $1,700 for self-only coverage or $3,400 for family plans. Plus, the plan’s cap on yearly out-of-pocket expenses — deductibles, co-payments and other amounts — can’t exceed $8,500 for individual plans or $17,000 for family coverage.

Investors have until the tax deadline to make HSA contributions for the previous year. That means the last chance for 2026 deposits is April 2027.

HSAs have triple-tax benefits

If you’re eligible to make HSA contributions, financial advisors recommend investing the balance for the long-term rather than spending the funds on current-year medical expenses, cash flow permitting.

The reason: “Your health savings account has three tax benefits,” said certified financial planner Dan Galli, owner of Daniel J. Galli & Associates in Norwell, Massachusetts.

There’s typically an upfront deduction for contributions, your balance grows tax-free and you can withdraw the money any time tax-free for qualified medical expenses.

Unlike flexible spending accounts, or FSAs, investors can roll HSA balances over from year to year. The account is also portable between jobs, meaning you can keep the money when leaving an employer.

That makes your HSA “very powerful” for future retirement savings, Galli said.

Healthcare expenses in retirement can be significant. A single 65-year-old retiring in 2024 could expect to spend an average of $165,000 on medical expenses through their golden years, according to Fidelity data. This doesn’t include the cost of long-term care.

Most HSAs used for current expenses

In 2024, two-thirds of companies offered investment options for HSA contributions, according to a survey released in November by the Plan Sponsor Council of America, which polled more than 500 employers in the summer of 2024.

But only 18% of participants were investing their HSA balance, down slightly from the previous year, the survey found.

“Ultimately, most participants still are using that HSA for current health-care expenses,” Hattie Greenan, director of research and communications for the Plan Sponsor Council of America, previously told CNBC.

Build emergency and retirement savings at the same time

Personal Finance

There’s a higher 401(k) catch-up contribution for some in 2025

Published

1 day ago

May 2, 2025

Business Finance News

Richvintage | E+ | Getty Images

If you’re an older investor and eager to save more for retirement, there’s a big 401(k) change for 2025 that could help boost your portfolio, experts say.

Americans expect they will need $1.26 million to retire comfortably, and more than half expect to outlive their savings, according to a Northwestern Mutual survey, which polled more than 4,600 adults in January.

But starting this year, some older workers can leverage a 401(k) “super funding” opportunity to help them catch up, Tommy Lucas, a certified financial planner and enrolled agent at Moisand Fitzgerald Tamayo in Orlando, Florida, previously told CNBC.

More from FA Playbook:

Here’s a look at other stories impacting the financial advisor business.

Here’s what investors need to know about this new 401(k) feature for 2025.

Higher ‘catch-up contributions’

For 2025, you can defer up to $23,500 into your 401(k), plus an extra $7,500 if you’re age 50 and older, known as “catch-up contributions.”

Thanks to Secure 2.0, the 401(k) catch-up limit has jumped to $11,250 for workers age 60 to 63 in 2025. That brings the max deferral limit to $34,750 for these investors.

Here’s the 2025 catch-up limit by age:

50-59: $7,500
60-63: $11,250
64-plus: $7,500

However, 3% of retirement plans haven’t added the feature for 2025, according to Fidelity data. For those plans, catch-up contributions will automatically stop once deferrals reach $7,500, the company told CNBC.

Of course, many workers can’t afford to max out 401(k) employee deferrals or make catch-up contributions, experts say.

For plans offering catch-up contributions, only 15% of employees participated in 2023, according to the latest data from Vanguard’s How America Saves report.

‘A great tool in the toolbox’

The higher 401(k) catch-up is “a great tool in the toolbox,” especially for higher earners looking for a tax deduction, said Dan Galli, a CFP and owner of Daniel J. Galli & Associates in Norwell, Massachusetts.

While pretax 401(k) contributions offer an up-front tax break, you’ll owe regular income taxes on withdrawals, depending on your future tax bracket.

Upper-income consumers stressed: Here's why

However, your eligibility for higher 401(k) catch-up contributions hinges what age you’ll be on Dec. 31, Galli explained.

For example, if you’re age 59 early in 2025 and turn 60 in December, you can make the catch-up, he said. Conversely, you can’t make the contribution if you’re 63 now and will be 64 by year-end.

On top of 401(k) catch-up contributions, big savers could also consider after-tax deferrals, which is another lesser-known feature. But only 22% of employer plans offered the feature in 2023, according to the Vanguard report.

Don’t miss these insights from CNBC PRO

Personal Finance

Trump’s tax package could include ‘SALT’ relief. Who could benefit

Published

1 day ago

May 2, 2025

Business Finance News

U.S. Representative Josh Gottheimer (D-NJ) speaks during a press conference about the SALT Caucus outside the United States Capitol on Wednesday February 08, 2023 in Washington, DC.

Matt McClain | The Washington Post | Getty Images

As debates ramp up for President Donald Trump‘s policy agenda, changes to a key tax provision could benefit higher earners, experts say.

Enacted via the Tax Cuts and Jobs Act, or TCJA, of 2017, there’s a $10,000 limit on the federal deduction on state and local taxes, known as SALT, which will sunset after 2025 without action from Congress.

Currently, if you itemize tax breaks, you can’t deduct more than $10,000 in levies paid to state and local governments, including income and property taxes.

Raising the SALT cap has been a priority for certain lawmakers from high-tax states like California, New Jersey and New York. With a slim House Republican majority, those voices could impact negotiations.

While Trump enacted the $10,000 SALT cap in 2017, he reversed his position on the campaign trail last year, vowing to “get SALT back” if re-elected. He has renewed calls for reform since being sworn into office.

Lawmakers have floated several updates, including a complete repeal, which seems unlikely with a tight budget and several competing priorities, experts say.

“It all has to come together in the context of the broader package,” but a higher SALT deduction limit could be possible, said Garrett Watson, director of policy analysis at the Tax Foundation.

Here’s who could be impacted.

How the SALT deduction works

When filing taxes, you choose the greater of the standard deduction or your itemized deductions, including SALT capped at $10,000, medical expenses above 7.5% of your adjusted gross income, charitable gifts and others.

Starting in 2018, the Tax Cuts and Jobs Act doubled the standard deduction, and it adjusts for inflation yearly. For 2025, the standard deduction is $15,000 for single filers and $30,000 for married couples filing jointly.

Because of the high threshold, the vast majority of filers — roughly 90%, according to the latest IRS data — use the standard deduction and don’t benefit from itemized tax breaks.

Typically, itemized deductions increase with income, and higher earners tend to owe more in state income and property taxes, according to Watson.

Who benefits from a higher SALT limit

Generally, higher earners would benefit most from raising the SALT deduction limit, experts say.

For example, one proposal, which would remove the “marriage penalty” in federal income taxes, involves increasing the cap on SALT deduction for married couples filing jointly from $10,000 to $20,000.

That would offer almost all the tax break to households making over $200,000 per year, according to a January analysis from the Tax Policy Center.

“If you raise the cap, the people who benefit the most are going to be upper-middle income,” said Howard Gleckman, senior fellow at the Urban-Brookings Tax Policy Center.

Of course, upper-middle income looks different depending on where you live, he said.

Forty of the top fifty U.S. congressional districts impacted by the SALT limit are in California, Illinois, New Jersey or New York, a Bipartisan Policy Center analysis from before 2022 redistricting found.

If lawmakers repealed the cap completely, households making $430,000 or more would see nearly three-quarters of the benefit, according to a separate Tax Policy Center analysis from September.