With last year’s budget reconciliation bill – also known as H.R. 1 and the “Big Beautiful Bill Act” – requiring most Medicaid beneficiaries to have jobs or participate in community engagement activities beginning next year, the states continue to develop and refine the policies and practices they will need to implement and enforce the new requirements.
The KFF has surveyed state Medicaid officials to identify what the states are doing and how they are doing it. Among Kaiser’s findings:
- Three states intend to implement the new Medicaid work requirements this year – ahead of the January 2027 implementation deadline – and a fourth will do so partially.
- Several states plan to employ more stringent approaches to verifying compliance with new work requirements than required by federal law.
- In keeping with Medicaid officials’ suggestion that states use resources other than beneficiary applications to verify work and
- community engagement status, more than a third of the states will use new data sources for this purpose. Fifteen states are using SNAP data for this purpose.
- More than half of the states will adopt at least one of the four types of hardship exemptions to the Medicaid work/community engagement requirement and only two will not adopt any such exemption.
- Six states are using AI to help implement work requirements and others are exploring the possibility of doing so.
Learn more about what the states are doing to prepare to enforce the new Medicaid work/community engagement requirements from the following KFF resources: “An Early Look at Policy Decisions as States Get Ready to Implement Work Requirements;” “Survey of Medicaid Eligibility Based on Disability or Age 65+ (non-MAGI eligibility);” and this Kaiser news release.
