Several Republican-led states are starting to craft Medicaid work requirement policies for next year that are stricter than required by law, making it tougher for able-bodied adults to remain on the social safety net program.

Several states with Republican governments, including Indiana, New Hampshire, Iowa, and others, are planning to do more than the minimum required under the One Big Beautiful Bill Act, signed by President Donald Trump last year, to implement work requirements for nondisabled Medicaid enrollees, according to a new state survey from the health policy group KFF.