The Centers for Medicare & Medicaid Services has issued additional guidance to the states on how to implement the work and community engagements established as part of the criteria for Medicaid eligibility under H.R. 1, commonly known as the One Big Beautiful Bill Act, which was signed into law in July.
The requirements seek to connect able-bodied, working-age adults with work and community engagement activities and reduce inappropriate Medicaid enrollment. The states are required to implement these requirements by January 1, 2027 but may do so sooner if they wish.
In providing this guidance, CMS enumerates four major principles, quoted below:
- Connect Members to Work and Community. Center the connection between health and work through community engagement and build habits that lead to success.
- State Flexibility. Balance the benefits of state flexibility with the potential costs of options, including systems and operational costs.
- Promote Alignment. Where possible, align policies with existing statutory and regulatory requirements including existing requirements for Medicaid, SNAP, TANF, IRS, and the Marketplace. This will help defray operations costs and streamline business flows.
- Protect Taxpayers. Ensure state community engagement determinations and verifications are easily auditable.
Learn more about this latest guidance from this CMS news release; from this new, additional CMS guidance to the states; and from previous guidance CMS sent to the states last month.