The Centers for Medicare & Medicaid Services (CMS) has issued new guidance to states on implementing community engagement requirements as part of the Working Families Tax Cut (WFTC) legislation, Public Law 119-21. These reforms are among the most significant changes to Medicaid eligibility and financing in over a decade. They aim to connect able-bodied, working-age adults with work and community engagement opportunities, reduce improper enrollment, and ensure the long-term sustainability of Medicaid and the Children's Health Insurance Program (CHIP). States have until January 1, 2027, to implement these requirements but may choose to do so earlier.
Health and Human Services Secretary Robert F. Kennedy, Jr., expressed satisfaction with the guidance, stating it restores "the dignity of work" while supporting Medicaid's sustainability for vulnerable populations. CMS Administrator Dr. Mehmet Oz emphasized that these reforms encourage individuals' potential by providing support on their path to prosperity.
The community engagement requirements align Medicaid with other public benefits like SNAP and TANF, which have used similar policies for decades. The policy development will be guided by four principles: connecting members to work and community; balancing state flexibility with potential costs; promoting alignment with existing statutory requirements; and protecting taxpayers through auditable determinations.
An Informational Bulletin released on November 18 outlines additional eligibility and financing reforms under the WFTC legislation aimed at ensuring lawful enrollment, reducing financing loopholes, and protecting rural hospitals. This guidance is part of a series of documents CMS plans to issue to support WFTC implementation.
For more information, visit www.medicaid.gov/medicaidreforms.
