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As required by Section 71119 of Public Law 119-21 (Working Families Tax Cut legislation), beginning January 1, 2027, states must condition Medicaid eligibility for “applicable individuals” on their demonstration of community engagement, unless a state opts to implement community engagement sooner.
Community engagement has potential to empower Medicaid beneficiaries through employment, education, or volunteer service so they can escape isolation and dependency, build confidence, and achieve self-sufficiency.
Implementation of the new community engagement requirements will necessitate major system, policy, and operational changes to state programs in the coming years. CMS is committed to supporting states in this effort and anticipates that ongoing partnership and engagement with states and other stakeholders will inform areas of need for additional guidance, including rulemaking by June 2026.