Implementing Community Engagements Requirements in Medicaid

Chapter 1 contains a recommendation to create a transparent plan for monitoring and evaluating community engagement (CE) requirements in Medicaid. Under the 2025 Budget Reconciliation Act (P.L. 119-21), states will be required to make Medicaid eligibility for certain applicants and existing beneficiaries contingent on their participation in qualifying CE activities. The chapter outlines the need for timely guidance and technical assistance to states; steps to reduce coverage losses; the need for efficiency when procuring, updating, and operating state information technology systems; and the use of timely monitoring and evaluation data to inform policy and operations. MACPAC’s research highlights the need to monitor eligibility and enrollment changes following implementation of the CE requirement.