Medicaid changes announced: Trump admin provides update on new eligibility requirements
The Centers for Medicare & Medicaid Services (CMS) has shared an update on new Medicaid eligibility requirements.
The Centers for Medicare & Medicaid Services (CMS) has shared an update on new Medicaid eligibility requirements. Recipients are now required to complete at least 80 hours of work or community service per month.
CMS said that 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.” It added that the reforms “aim 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).”
States must implement these requirements by January 1, 2027, or earlier.
The measures, brought in by President Donald Trump's 'One Big Beautiful Bill', requires all Medicaid enrollees, unless otherwise exempt, to complete and report 80 hours of work each month. The work could include a job, community work, volunteering or education.
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According to the administration, working requirements were added in an attempt to reduce fraudulent claims, improve personal responsibility and boost employment. However, critics believe that the move will end up forcing some off the program because of the administrative burden of reporting and proving eligibility.
Some states had adopted similar requirements even before the bill was passed. However, now all states will have to implement the changes.
What to know about the new working requirements
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), CMS stated. The agency advised that states must make sure 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," it added.
The agency advised states to "protect taxpayers” by ensuring "state community engagement determinations and verifications are easily auditable." It also outlined a total of $200 million in fiscal 2026 for states to establish the systems needed to carry out the measures. States have the power to choose whether they want recipients to demonstrate their community engagement for one, two or three consecutive months before January 1, 2027.
“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,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “Federal programs that foster community engagement help American citizens live healthy and fulfilling lives.”
“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,” said CMS Administrator Dr. Mehmet Oz. “These reforms send a clear message: you have agency, your contributions matter, and we will support you on the path to purpose and prosperity.”
