The Trump administration's CMS rule, released June 2025, codifies work or school mandates tied to the 2025 tax legislation, mandating state verification processes and exemptions for caregivers, disabled individuals, and students while projecting $326 billion in federal savings and 5.3 million coverage losses. Beyond the STAT reporting, this echoes Arkansas's 2018-2019 experiment where an observational study of over 100,000 enrollees found an 18% drop in Medicaid participation with no statistically significant rise in employment (Sommers et al., NEJM 2019; quasi-experimental design, no RCT, limited by self-reported data and no conflicts disclosed). Georgia's partial implementation similarly yielded minimal workforce entry per state audits. Peer-reviewed analyses, including a Health Affairs review of multiple state waivers, indicate these policies disproportionately affect rural and chronically ill adults who face verification barriers, contradicting the HHS brief's poverty-reduction claims derived from non-peer-reviewed modeling. The rule's narrow exemptions risk repeating patterns where eligible beneficiaries lose coverage due to administrative hurdles rather than true non-compliance.