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Background on Work and Community Engagement Requirements in Medicaid

For the first time, states will soon be required to make Medicaid eligibility for certain applicants and existing beneficiaries contingent on their participation in qualifying community engagement activities in accordance with Public Law 119-21, an Act to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14 (2025 Budget Reconciliation Act, P.L. 119-21). This session provided an overview of the new community engagement requirement in the 2025 Budget Reconciliation Act. The presentation also outlined the history of work and community engagement requirements in Medicaid, including the experiences of states that implemented such requirements under Section 1115 demonstration authority.