Sponsors (5)
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
Conditions federal Medicaid matching funds for most adults on meeting a new monthly “community engagement” requirement of at least 80 hours of work, community service, education, or job program participation (or equivalent earnings). If an eligible adult fails to meet that requirement for three or more months in a calendar year, the federal government would not pay the Medicaid match for medical assistance that month, and states could choose to disenroll the person from Medicaid for months with no federal match. The law defines who is excluded (children, adults 65+, pregnant people, certain caregivers, medically unfit individuals, people in treatment, students enrolled half-time, and others) and requires states to verify compliance using existing databases before asking beneficiaries for extra paperwork. It changes federal Medicaid payment rules and gives states the option to remove noncompliant beneficiaries from their rolls.
The bill aims to encourage work and reduce paperwork by allowing states to verify an 80-hour monthly work/service requirement via administrative records, but it raises a high risk of disenrolling vulnerable Medicaid beneficiaries and shifting costs to hospitals and individuals.
Low-income Medicaid recipients may face stronger incentives to meet an 80-hour monthly work or community-service requirement, which could increase employment and earnings for some beneficiaries.
States can verify compliance using administrative databases before contacting individuals, reducing paperwork and administrative burden for beneficiaries and state agencies.
Medicaid beneficiaries — especially parents, people with unstable jobs, caregivers, and people with disabilities (including those without formal documentation) — risk losing coverage if they cannot meet an 80-hour monthly requirement, likely increasing uninsured rates and harming access to care.
States may be incentivized to remove coverage for noncompliant enrollees to avoid costs, shifting care and costs to hospitals and emergency services and increasing out-of-pocket and uncompensated care burdens.
Relying on administrative databases to verify compliance risks erroneous eligibility terminations if records are incomplete or mismatched, causing wrongful disenrollments and interruptions in care.
Introduced February 13, 2025 by Aaron Bean · Last progress February 13, 2025