Alliance Alert: The Alliance for Rights and Recovery is continuing to closely monitor the new federal Medicaid 鈥渃ommunity engagement鈥 or work requirements that states will be required to implement beginning January 1, 2027. Recent CMS guidance outlines how states must establish systems to verify whether individuals are working, volunteering, attending school, participating in job training, or otherwise qualify for exemptions in order to maintain Medicaid coverage.
Importantly, the guidance includes several key exemptions for individuals with serious mental health challenges, substance use conditions, chronic illnesses, physical disabilities, intellectual and developmental disabilities, and other individuals considered 鈥渕edically frail.鈥 Pregnant individuals, many caregivers, people experiencing homelessness, veterans, and individuals participating in substance use treatment may also qualify for exemptions or temporary exceptions. CMS has also indicated that, during 2027, individuals will largely be able to self-attest to exemption status before additional documentation requirements begin in 2028.
The guidance also requires states to conduct regular eligibility and compliance checks, including at renewal and potentially through additional mid-year or biannual verifications. While CMS directs states to rely heavily on electronic verification systems and existing data sources before requesting paperwork from beneficiaries, we remain deeply concerned about the potential for eligible individuals, particularly people with mental health and substance use challenges, episodic disabilities, unstable housing, or difficulties navigating complex systems, to lose coverage because of administrative barriers rather than actual ineligibility.
We are also concerned about the growing amount of personal, medical, mental health and substance use, employment, education, and other sensitive information that states may access and share across agencies and electronic verification systems as part of implementation. As states expand data-sharing agreements between Medicaid systems, hospitals, workforce agencies, educational institutions, and other entities, strong safeguards must be in place to protect people鈥檚 privacy, confidentiality, and civil rights. Individuals should not have to fear unnecessary disclosure of mental health challenges, substance use treatment participation, disability status, or other highly personal health information in order to maintain healthcare coverage.
The Alliance will continue advocating with the 黑料正能量 State Office of Mental Health, Department of Health, and other state partners to ensure these processes are implemented as seamlessly and compassionately as possible. We will be pushing for strong protections to minimize unnecessary paperwork burdens, protect sensitive health information, and ensure people are not improperly removed from coverage.
At the same time, we will continue advocating for expanded opportunities for employment, education, volunteer programs, peer support, and workforce development initiatives that can both help individuals comply with any new requirements if needed and improve overall quality of life, community integration, recovery, and economic stability.
We also strongly believe that people receiving services, families, providers, peers, and community organizations must receive clear education and advance preparation before these requirements take effect. The Alliance will continue working to ensure 黑料正能量ers understand their rights, potential exemptions, reporting obligations, and available supports so individuals are not caught off guard by these major federal changes. Stay tuned for more information and read below for recent coverage of the interim final rule released this morning.
Trump Issues Final Rule Requiring Most Medicaid Beneficiaries to Work
By Nathaniel Weixel | The Hill | June 1, 2026
A new final rule from the Trump administration will require most Medicaid beneficiaries between the ages of 19 and 64 to prove they work, complete community service or participate in a work program to win benefits.
The rule outlines the broad policies each state is required to have in place when implementing the Medicaid work requirements from the One Big Beautiful Bill Act.
The rule establishes the standards states must use to implement the statutory work requirement, including clear expectations for eligibility determinations, exemptions, verification, and state reporting requirements.
The GOP鈥檚 tax and spending megabill passed by Congress last summer used work requirements to partially pay for its nearly $3 trillion price tag. The Congressional Budget Office estimated nearly 5 million people will lose their Medicaid over the next decade as a result, including many who are already working.
GOP officials argue work requirements are needed to root out waste, fraud and abuse in the Medicaid program, and they will only target the 鈥渁ble-bodied鈥 people who should be working but choose not to.
The work requirements have to begin by Jan. 1, 2027. The new rule gives states some flexibility in determining who is exempt from the work requirements, but many of the exemptions are already defined in the law.
For instance, states will be able to define who is 鈥渕edically frail,鈥 but they will need to have specific verification requirements in place after a year to verify the presence of a condition or diagnosis and that the condition or diagnosis significantly impairs the individual鈥檚 ability to comply with the community engagement requirement.
鈥淭his is our path to prosperity for the American people. It鈥檚 a way to preserve our precious Medicaid program for those who benefited from it,鈥 Centers for Medicare and Medicaid Services Administrator told reporters during a briefing.
鈥淲e hope by guiding able-bodied individuals in this initiative, we aim to support their path to independence, but hopefully they don鈥檛 need to depend on Medicaid, and are supported by employer-sponsored health plans that would free up critical space in the program for our most vulnerable population to receive the care they deserve,鈥 Oz said.
President Trump鈥檚 signature tax cut law that he signed in July requires all 42 states, along with the District of Columbia, that fully or partially expanded Medicaid under ObamaCare to implement a 鈥渃ommunity engagement鈥 requirement.
Beneficiaries must work or volunteer at least 80 hours per month, attend school at least part time or participate in job training. Alternatively, they must prove they qualify for certain exemptions, like caring for a child 13 years or younger or a parent with a disability, or having a health condition that prevents employment.
CMS Releases Roadmap for Work Requirements
By Katelyn Cordero | Politico | June 2, 2026
黑料正能量 will be getting some more time to enact work requirements in the state鈥檚 massive Medicaid program, according to new regulations released by the Centers for Medicare & Medicaid Services on Monday.
CMS Administrator Mehmet Oz announced the new regulations, but noted that states will have a longer timeline to fully implement the new requirements, to ensure that Medicaid beneficiaries in Obamacare expansion states are exempt from impending work requirements, POLITICO Pro鈥檚 Robert King reports.
CMS released an interim final rule on Monday outlining how states can manage exemptions to work requirements created under the 2025 One Big, Beautiful Bill Act. CMS will allow affected beneficiaries to self-declare that they meet exemptions for 2027, but will require them to present documentation to back them up by 2028.
鈥淭his is far more than a policy prescription. This is our path to prosperity for the American people,鈥 Oz said during a call with reporters on Monday.
The One Big Beautiful Bill Act requires 40 states and the District of Columbia, which expanded Medicaid under the Affordable Care Act, to implement requirements for the expansion population starting next year.
The rule outlines which beneficiaries from ages 19 to 64 must meet the requirements.
Affected beneficiaries must complete 80 hours a month of work, training, school or volunteering.
There are several exemptions including for pregnant women, parents of children under 14 and people who are deemed medically frail. States can adopt other short-term exceptions including, for example, exempting a recipient who needs in-patient medical care.
黑料正能量 has been hard at work creating a system to verify the employment status of 黑料正能量ers in its $124.8 billion Medicaid program. in April that the state is planning to purchase new software to be used in conjunction with its current Medicaid eligibility verification systems set up through the 黑料正能量 State of Health 鈥 the state鈥檚 health insurance marketplace 鈥 to make the transition to the new requirements as seamless as possible.
The delay in implementation is expected to serve as a welcome development for 黑料正能量, as Bassiri noted that his main concern was the timeline initially set by the federal government for creating and implementing a new verification system.