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Section 71119 (Requirement for States to Establish Medicaid Community Engagement Requirements for Certain Individuals) of Public Law 119-21 amended section 1902 of the Social Security Act (the Act) to add subsection (xx). Section 1902(xx) of the Act requires states and the District of Columbia to ensure that applicable individuals demonstrate, as a condition of their Medicaid eligibility, a minimum number of community engagement hours (generally, that they work, are enrolled in an educational program, complete community service, participate in a work program, or any combination thereof) for a minimum period of time preceding their application and during their enrollment. The requirements of section 1902(xx) of the Act are effective beginning January 1, 2027, unless a state opts to implement the requirements sooner. Section 71119 also requires the agency to promulgate an interim final rule to implement 1902(xx) of the Act no later than June 1, 2026.

Overall Description of Deadline: Section 71119 of Public Law 119-21 requires the agency to promulgate an interim final rule no later than June 1, 2026, to implement the requirements established by such section beginning January 1, 2027 (or earlier date at state option).

Statement of Need:

As required by statute, beginning January 1, 2027, states must condition eligibility for applicable individuals on their demonstration of community engagement (generally, that they work, are enrolled in an educational program, complete community service, participate in a work program, or any combination thereof, or meet an exception), unless a state opts to implement community engagement sooner.

Summary of the Legal Basis:

Section 71119 of the Working Families Tax Cut Act (Pub L. 119-21) requires that we promulgate an interim final rule to implement 1902(xx) of the Act no later than June 1, 2026.

Alternatives:

None. This rule implements a statutory requirement.

Anticipated Costs and Benefits:

As we move toward publication, estimates of costs and benefits will be included in the rule.

Risks:

Risks associated with the impact of this rule are under development and will be included in the published rule.