CMS proposes work requirements for some Medicaid enrollees in expansion states

The Centers for Medicare & Medicaid Services (CMS) has published an interim final rule that would require certain non-disabled adults enrolled in Medicaid through the ACA expansion to show they are working, volunteering, or participating in job training. This requirement applies only to states that have chosen to expand their Medicaid programs to cover low-income adults between ages 19 and 64.

Why it matters: This action shifts the structure of Medicaid eligibility in expansion states by adding behavioral conditions to financial ones. For states opting into this framework, it creates a new administrative layer for verifying work or volunteer status. For enrollees, it introduces the risk of losing health coverage due to non-compliance with activity reporting, even if they remain financially eligible.

Who it affects

• States that have expanded Medicaid under the ACA (40 states and D.C.)

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This is an interim final rule from the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register; readers should consult the full document for specific implementation timelines and state-level options.

Agency: Health and Human Services Department, Centers for Medicare & Medicaid Services
Source: Federal Register — read the official document