United States

A breakdown of new policy guidance for states: Work/community engagement requirements for Medicaid

Jan 25, 2018
From the Government Institute

The Centers for Medicare & Medicaid Services (CMS) issued policy guidance on January 11, 2018, outlining key components for states looking to gain approval for 1115 waivers testing Medicaid work/community engagement for able bodied adults. The following day, CMS approved Kentucky’s 1115 waiver application. In addition to Kentucky, nine other states have filed to include work requirements as a condition for Medicaid eligibility.

The concept of work or community engagement requirements in public assistance programs is not new. However, applying these requirements to Medicaid is new and previous state applications for such requirements were consistently rejected by the Obama Administration.

This issue brief summarizes and puts into context the work/community engagement guidance provided by CMS in the Guidance Letter and briefly outlines key work/community engagement features of Kentucky’s approved demonstration program.


Eveline Van Beek

Eveline Van Beek

Managing Director, Health and Human Services