By Shalina Chatlani, Stateline.org

States must begin verifying millions of Medicaid enrollees’ monthly work status by the end of next year — a task some critics say states will have a hard time carrying out.

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A provision in the tax and spending bill President Donald Trump signed into law July 4 will require the 40 states plus Washington, D.C., that have expanded Medicaid to check paperwork at least twice a year to ensure those enrollees are volunteering or working at least 80 hours a month or attending school at least half time.

The new law provides states $200 million for fiscal year 2026 to get their systems up and running. But some experts say states will have difficulty meeting the deadline with that funding and worry enrollees might lose their health benefits as a result.

A year and a half to comply is likely not going to be enough time for most states, especially since the federal government must craft guidance on how they should implement their programs, said Dr. Benjamin Sommers, a health economist at Harvard T.H. Chan School of Public Health. He predicted it will be difficult to create technology simple enough — such as a phone app — to streamline the process for all enrollees.

“Two hundred million [dollars] is not going to cover the 40 expansion states that we have,” he told Stateline. “There is not a silver bullet here, and there isn’t a single app out there that’s going to keep people who should be in Medicaid from losing coverage. That’s just not realistic.”

A spokesperson for the North Carolina Department of Health and Human Services, Hannah Jones, told Stateline that “it will take a significant amount of time and investment in order to implement work requirements.”

Jones said an estimated 255,000 people in North Carolina could lose coverage because of these requirements and their “administrative burden.”

“More automation reduces manual work on beneficiaries and eligibility case workers, but it requires more time, funding, and staff resources to implement,” Jones wrote in an email.

Emma Herrock, a spokesperson for the Louisiana Department of Health, wrote in an email that the vast majority of the state’s Medicaid enrollees already work, and the agency expects few people to be disenrolled. Herrock said the department will establish work verification systems by the end of 2026.

“The department is taking a thoughtful approach to implementation,” Herrock wrote. “We are already working with several Louisiana agencies … in order to receive data on recipients who are working.”

She added that the department views work requirements “as a means to grow our economy, while reinforcing the value of work and self-sufficiency.”

In New York, it could cost the state $500 million to administer the new requirements, New York Department of Health spokesperson Danielle De Souza wrote in an email.

Between 600,000 and 1.1 million individuals who are eligible for and enrolled in Medicaid could potentially lose coverage because of work reporting requirements, she wrote, based on what happened when states were required to resume checking eligibility after the COVID-19 health emergency ended.

“The department will remain steadfast in its commitment to protecting the health of all New Yorkers and will work to mitigate the impacts of this law,” De Souza wrote.

The new rules apply to states that expanded Medicaid to adults between the ages of 19 and 64 with incomes below 138% of the federal poverty line (about $22,000 for an individual), an option that was made available under the 2010 Affordable Care Act. More than 20 million people were enrolled through Medicaid expansion as of June 2024 — those are the patients who will face work requirements.

Reapplying for Medicaid, which typically has been required once a year, already is burdensome for some patients, said Dr. Bobby Mukkamala, president of the American Medical Association.

“On top of that, now we’re going to be challenging so many people who were at least able to deal with it financially with things like … proving that they got a job,” Mukkamala said in an interview.

Previous attempts at implementing work requirements have ended up costing states millions in administrative and consulting fees. And in some cases, people who were eligible for Medicaid lost their coverage due to paperwork issues.

Arkansas’ example

Several states wanted to implement work requirements during the first Trump administration. But only Arkansas fully did so, in 2018, before a federal judge halted the requirements. More than 18,000 Arkansas residents lost Medicaid coverage during the 10 months the requirements were in effect.

Sommers, of Harvard, noted that most people were disenrolled because they didn’t know about the policy or made paperwork errors, not because they weren’t working.

“Red tape led to people losing their coverage,” he said. “They had more trouble affording their medications. They were putting off needed care.”

Brian Blase, president of the Paragon Health Institute, a conservative policy group that advises congressional Republicans, said he thinks concerns about the new requirements are overblown because there’s more advanced technology now.

“Lots of government programs have initial implementation challenges,” Blase told Stateline. “Arkansas was seven years ago, and if you just think about the change in the technological advancements over the past seven years … we didn’t have artificial intelligence and just the ability of modern tech.”

As it stands, each state has varying technological capabilities, and will have a different timeline and budget, said Michael Heifetz, a managing director at consulting firm Alvarez & Marsal and a former Medicaid director in Wisconsin. His team contracts with states to implement Medicaid, including work requirements, and other programs.

He also noted that the Trump administration can give states a deadline extension on implementing work requirements to Dec. 31, 2028, if they show they are making a “good faith effort.” States will need to share data across agencies in new ways, he said.

“It will require some form of data sharing and communications with educational agencies, workforce training agencies and some other agencies that typically aren’t in the Medicaid ecosystem,” Heifetz said.

State governments may resist hiring full-time positions for those tasks, he said, but “artificial intelligence and other tools can help work through these processes in a smoother fashion.”

Other state efforts

Efforts in other states to implement work requirements have had mixed results.

In Georgia, for example, an experimental work requirement program cost taxpayers more than $86 million in its first 18 months but enrolled just 6,500 people during that time, according to an investigation by ProPublica and The Current published in February. That’s 75% fewer participants than the state had estimated for the program’s first year.

The nonpartisan U.S. Government Accountability Office in 2019 looked at five states that tested systems to track Medicaid work requirements under the first Trump administration. Those demonstration projects were rescinded during the Biden administration.

The states estimated their projected administrative costs for implementing work requirements for one to three years, and the total far surpassed the $200 million Congress has provided in the new law. Kentucky alone estimated $270 million, Wisconsin $70 million, Indiana $35 million, Arkansas $26 million and New Hampshire $6 million.

Susan Barnidge, an assistant director on the GAO health care team and an author of the report, said the agency found that across states there wasn’t much federal oversight of administrative costs on test programs. Oversight will be key as states roll out their work requirement systems, she said.

“We found some weaknesses in [federal] Centers for Medicare & Medicaid oversight of certain federal funding for certain administrative activities. So we found examples of things that states sought federal funding for that didn’t appear to be allowable,” Barnidge said in an interview. “I think that will remain relevant.”

Mukkamala, of the American Medical Association, said the burden will in some ways fall to doctors’ offices to help keep patients enrolled, as they work with patients to check eligibility and possibly help get them on Medicaid. He works in Flint, Michigan, as an otolaryngologist, or ear, nose and throat doctor, and said a third of his patients are on Medicaid.

“As if it’s easy to take care of their health care issue, given things like prior authorization,” Mukkamala told Stateline. “Now to add to the challenge, we have to figure out how to get them covered.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

PARIS (AP) — With the support of international partners and the mobilization of $115 million, the U.N. cultural agency UNESCO recently helped rebuild the Iraqi city of Mosul after it was devastated by the Islamic State group.

The restoration of the historic city’s iconic Al-Nouri Mosque and Al-Hadba Minaret was just one of many programs run by the U.N. Educational, Scientific and Cultural Organization, which is in the spotlight because the United States is leaving it once again.

The UNESCO flag flies at its headquarters Tuesday, July 22, 2025 in Paris. (AP Photo/Thomas Padilla)

The decision to pull U.S. funding and participation from UNESCO will deal a blow to its work preserving cultural heritage around the world. President Donald Trump exited the agency during his first term, accusing it of promoting anti-Israel speech. The Biden administration had rejoined UNESCO in 2023 after citing concerns that China was filling the gap left by the U.S. in UNESCO policymaking.

Beyond the diplomatic disputes, here’s a look at the work that UNESCO does:

World Heritage Sites

UNESCO names World Heritage sites, including landmarks like the Great Wall of China, the Egyptian pyramids, the Taj Mahal and the Statue of Liberty, and gives them special protection under its World Heritage Sites program.

Its World Heritage Committee each year designates sites considered “of outstanding value to humanity” and intervenes when sites are in danger of destruction or damage. The program provides countries with technical assistance and professional training to preserve the sites.

A man enters the UNESCO headquarters Tuesday, July 22, 2025 in Paris. (AP Photo/Thomas Padilla)

It now also includes “intangible” heritage such as folk songs and traditional dances, crafts and cooking in its lists. A World Heritage site designation is coveted and seen as a boost to tourism.

Holocaust Education

Like the rest of the U.N., UNESCO was created in response to the horrors of World War II, and particularly Nazi crimes. Amid concerns that the agency’s Arab members have used UNESCO to pass anti-Israel resolutions, UNESCO has worked in recent years on Holocaust awareness projects. That includes educational materials and organizing visits to former Nazi concentration camps.

Empowering Girls

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UNESCO works to improve literacy, with a special focus on girls in countries hit by war or disasters who get little or no schooling though programs such as the Malala Fund for Girls’ Right to Education. In Tanzania, for instance, over 2,500 girls benefited from the creation of safe spaces in 40 secondary schools, The agency provides teacher training and materials and encourages programs for girls to pursue careers in science.

Climate Change

One of the agency’s goals is coordinating climate knowledge and improving international education about how global warming occurs and affects people around the world. Over 30 UNESCO programs are designed to help its members adapt to climate change and favor sustainable development.

Ethics of Artificial Intelligence

UNESCO adopted in 2021 what it calls “the first and only global standard-setting instrument on the ethics of artificial intelligence.” Applying to all 194 member states, the recommendation emphasizes the protection of human rights and dignity, grounded in principles like transparency, fairness, and human oversight of AI systems.

Operating without the U.S.

UNESCO director general Audrey Azoulay said the U.S. decision to leave was expected and that the agency has prepared for it. While the U.S. had previously provided a notable share of the agency’s budget, UNESCO has diversified its funding sources.

“Thanks to the efforts made by the organization since 2018, the decreasing trend in the financial contribution of the US has been offset, so that it now represents 8% of the organization’s total budget compared with 40% for some United Nations entities,” Azoulay said.

She added that the agency’s overall budget has increased and that it has the steady support of “a large number of member states and private contributors.”

By Tommy Tindall, NerdWallet

My wife and I hate our washer and dryer. Both appliances still operate, but the washer leaves behind what looks like little specs of mildew every load. The dryer takes three times on high to get a load dry.

All the trade war talk has us wondering if we should nab a deal now while it doesn’t seem so bad.

A lot of people are worried about tariffs, according to the Consumer Confidence Board’s June Consumer Confidence Index. The report said purchasing plans for appliances were slightly up in June, car-buying plans were steady and electronic-buying plans were down.

The affluent — and I’m not saying that’s me — may be leading the charge.

Back in May, 26% of consumers making $125,000 or more indicated that they’d made purchases ahead of potential tariffs. Expected price rises haven’t fully landed, but economists say they are coming.

“Consumers are seeing their way through the uncertainty with trade policies,” National Retail Federation Chief Economist Jack Kleinhenz said in a June prepared statement. “But I expect the inflation associated with tariffs to be felt later this year.”

If you want to get ahead of potential rising prices, here are a few things to look at now before they get more expensive later.

Major appliances, like washers and refrigerators

Turns out the tariff on imported steel and aluminum will specifically hit household appliances. As of June 23, the 50% tariff on steel extends to “steel derivative products,” which include fridges, freezers, washers, dryers, dishwashers, ovens and even garbage disposals.

If you’ve been thinking about upgrading an appliance, the time might be right to get something that was made before prices get higher, and while summer sales are still going on.

As for our purchase plan, we’re going to get a new washer and dryer soon because mildew is gross and economists foresee prices rising. Our local appliance store has the LG set we want in stock and on sale now.

Cars (especially EVs and luxury imports)

It was a crappy time to buy a car the past few years. Prices of both new and used cars ballooned after the pandemic. Then, the situation seemed to get better.

Case and point: I bought a brand new Honda Odyssey at several grand under sticker in November. I was shocked the dealer was willing to let me haggle that day. (Adding free all-weather mats was a non-starter though.) I also can’t believe how much I love driving a minivan (#babyonboard).

Now, a 25% tariff on imported passenger vehicles and auto parts could usher in a new era of crappiness in car buying, but there is time to get ahead of it.

“Experts expect tariffs to push car prices higher. We’ve seen a few manufacturers increase prices, but overall there haven’t been big increases. That’s expected to change though, as pre-tariff vehicles disappear,” says Shannon Bradley, NerdWallet’s authority on autos.

What make and model of car are you after, and where is it made?

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Consultancy firm Anderson Economic Group has analyzed vehicles with the lowest and highest potential tariff impact to project cost increases to consumers.

Cars like the Toyota Camry Hybrid, Ford Explorer and my beloved Honda Odyssey are assembled in the U.S. and expected to be less impacted by tariffs than more luxurious foreign-made models. Prices of the cars mentioned are expected to increase by $2,000 to $3,000.

Another incentive to get a new ride has to do with President Trump’s “big, beautiful bill.”

The legislation adds a tax deduction for car loan interest, where taxpayers can write off up to $10,000 a year in interest paid on new cars assembled in the U.S. and purchased after Dec. 31, 2024.

If you’re on the other end of the spectrum, looking for something like a Mercedes-Benz G-Wagon, Land Rover, Range Rover or imported BMW model, there’s no tax deduction, and the tariff impact is expected to be greater. Like $10,000 to $12,000 greater, according to the Anderson Economic Group analysis.

If you want an electric vehicle, the clock is ticking.

“EV tax credits will be eliminated beginning with EVs purchased or leased after Sept. 30, 2025. If you want an EV, buy one before then,” says Bradley.

The new Tesla Model 3 and Ford F-150 Lightning are examples of EV models eligible for the $7,500 EV tax credit for now. Used EVs get a tax credit of $4,000, but that will also end Sept. 30 under the planned tax changes.

iPhones and Androids

The tariffs situation changes almost daily.

Right now, there is a baseline 10% across-the-board tariff on all imports. There’s also a 30% tariff on Chinese imports in effect, with the potentially higher reciprocal tariffs on China and other countries on pause until Aug. 1.

Something you may not know is smartphones (along with 19 other electronic items and/or components, including laptops) are exempt from tariffs for the time being. That could influence your decision to upgrade your phone now, if you need to.

Imported booze

Does the idea of adding $12k to the cost of a luxury car make you reach for a drink? If so, you may want to stock up on Scotch, South African wine, sake and other imported alcohol and put them in the cellar now.

Unless new trade agreements come together, tariffs of 50% for the European Union, 30% for South Africa and 25% for Japan are on the table come Aug. 1.

Please drink expensive booze slowly and sparingly.

Advice: Don’t let tariffs tweak you out

Whatever you do, don’t panic-buy a fridge or a Ford F-150 Lightning because you’re worried. Saving money on the sticker price of something you don’t need or can’t afford is silly. Instead, assess your current situation and decide if your budget allows for buying something big-ticket.

It may be worth it to hold on to your money now and take steps to save and prepare for the additional cost later.

Tommy Tindall writes for NerdWallet. Email: ttindall@nerdwallet.com.

The article Splurge Now, Save Later? 4 Things to Buy Before Prices Rise originally appeared on NerdWallet.

By ALEX VEIGA, Associated Press Business Writer

LOS ANGELES (AP) — Sales of previously occupied U.S. homes slid in June to the slowest pace since last September as mortgage rates remained elevated and national median sales prices hit unprecedented levels.

Existing home sales fell 2.7% last month from May to a seasonally adjusted annual rate of 3.93 million units, the National Association of Realtors said Wednesday.

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Sales were flat compared with June last year. The latest home sales fell short of the 4.01 million pace economists were expecting, according to FactSet.

Home prices increased on an annual basis for the 24th consecutive month. The national median sales price rose 2% in June from a year earlier to $435,300, an all-time high.

The U.S. housing market has been in a slump since early 2022, when mortgage rates began to climb from pandemic-era lows. Home sales fell last year to their lowest level in nearly 30 years.

So far this year, the average rate on a 30-year mortgage has remained relatively close to 7%, according to mortgage buyer Freddie Mac.

Homes purchased last month likely went under contract in May and June, when the average rate on a 30-year mortgage ranged from 6.76% to 6.89%.

High mortgage rates can add hundreds of dollars a month in costs for borrowers, limiting their purchasing power. The trend is a key reason for why this year’s spring homebuying season has been a bust.

“The second half of the year really depends on what happens with mortgage rates,” said Lawrence Yun, NAR’s chief economist.

The affordability constraints are limiting the activity of first-time buyers. They accounted for 30% of homes sales last month, unchanged from May. Historically, they made up 40% of home sales.

Home shoppers who can afford to buy at current mortgage rates or pay in cash are benefiting from more properties on the market.

There were 1.53 million unsold homes at the end of last month, down 0.6% from May, but up nearly 16% from June last year, NAR said. That’s still well below the roughly 2 million homes for sale that was typical before the pandemic, however.

June’s month-end inventory translates to a 4.7-month supply at the current sales pace, up from a 4.6-month pace at the end of May and 4 months in June last year. Traditionally, a 5- to 6-month supply is considered a balanced market between buyers and sellers.

Homes for sale are staying on the market longer as sales remain in the doldrums. Properties typically remained on the market for 27 days last month before selling, up from 22 days in June last year, NAR said.