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By Jasmine Laws
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The Centers for Medicare & Medicaid Services (CMS) has provided an update on new Medicaid eligibility requirements requiring recipients to complete at least 80 hours of work or community service per month.
The requirements outlined by the Working Families Tax Cut (WFTC) legislation are among the "most significant Medicaid eligibility and financing changes in more than a decade," CMS said.
The agency added that the aim was to "connect able-bodied, working-age adults with work and community engagement opportunities, reduce improper enrollment, and strengthen the long-term sustainability of Medicaid and the Children’s Health Insurance Program (CHIP)."
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Why It Matters
As part of the measures brought in by President Donald Trump's 'One Big Beautiful Bill', all Medicaid enrollees, unless otherwise exempt, must complete and report 80 hours of work—which could include a job, community work, volunteering or education—each month.
The administration said that working requirements were added as a way to reduce fraudulent claims, improve personal responsibility and boost employment. Critics have pushed back, saying that the move will force some off the program, not because of the requirements themselves, but because of the administrative burden of reporting and proving eligibility.
Some states had already adopted similar requirements prior to the bill's passage, but now all states will be required to implement the changes.
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What To Know
CMS said that the new working requirements would bring Medicaid "in line" with other public benefits like the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF), which it said "for decades have used similar policies to support beneficiaries on the path to prosperity."
The agency advised that, in their implementation of the policy, states should ensure they "connect members to work and community," and "balance the benefits of state flexibility with the potential costs of options, including systems and operational costs."
CMS said they should also "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," CMS said.
The agency also told states they should "protect taxpayers," meaning they should ensure "state community engagement determinations and verifications are easily auditable."
The agency also provided additional guidance for states, outlining a total of $200 million in fiscal 2026 for states to establish the necessary systems to carry out these measures.
Other financial resources have also been made available.
States can choose whether to require recipients to demonstrate their community engagement for one, two or three consecutive months before January 1, 2027, as part of their review of Medicaid eligibility.
What People Are Saying
Health and Human Services Secretary Robert F. Kennedy, Jr said in a statement: "I am very pleased that CMS is providing clear direction to states using breakthrough Medicaid community engagement tools that restore the dignity of work and lift people out of poverty, while supporting the sustainability of Medicaid for the most vulnerable. Federal programs that foster community engagement help American citizens live healthy and fulfilling lives."
CMS Administrator Dr. Mehmet Oz said in a statement: "For far too long, too many Americans who are able to work have been left isolated and discouraged by programs that don’t encourage their potential. These reforms send a clear message: you have agency, your contributions matter, and we will support you on the path to purpose and prosperity."
What Happens Next
All states are required to implement the community engagement requirements for Medicaid recipients by January 1, 2027, but some states could choose to move forward with the requirements earlier.
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