Medicaid to Require Community Engagement from 2027
Published Date: 6/3/2026
Rule
Summary
Starting January 1, 2027, some Medicaid adults will need to show they’re involved in their communities—like working, volunteering, or training—to keep their benefits. States must check this, help people understand the rules, and report on how it’s going. This change aims to encourage active participation while making sure no one who can’t meet the rules is left behind.
Analyzed Economic Effects
2 provisions identified: 1 benefits, 1 costs, 0 mixed.
Medicaid adults must do 80 hours/month
Starting January 1, 2027, some adults on Medicaid must show they do community engagement — such as work, volunteering, training, or education — for at least 80 hours each month to keep eligibility. States must check compliance at application and renewal, give a notice of noncompliance and 30 calendar days to show they are complying, and will disenroll people who remain noncompliant (individuals may reapply at any time). The rule is effective July 31, 2026 and States must meet the January 1, 2027 implementation deadline.
Many groups are excluded from requirement
The rule does not apply to certain people — for example, people who are pregnant, those under age 19 or age 65 and older, people enrolled in Medicare Part A or B, and certain other mandatory Medicaid groups (such as parents and caretaker relatives or individuals eligible based on SSI). States that do not cover the adult group or whose demonstration populations do not meet the law's criteria will not have applicable individuals.
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Key Dates
Department and Agencies
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