On December 8, 2025, the Centers for Medicare & Medicaid (CMS) released preliminary guidance on the community engagement requirements in the Working Families Tax Cuts legislation (WFTCL). The agency must publish an interim final rule by June 1, 2026, and the policies in the final rule will govern.
The WFTCL established an 80-hour per month community engagement requirement—colloquially referred to as work requirements—beginning on December 31, 2026, for the Medicaid expansion population and individuals receiving coverage through a waiver of the plan. The guidance notes that the agency is still evaluating which populations receiving coverage under a waiver will be subject to community engagement requirements.
Additionally, the guidance reiterates, as stated in the WFTCL, that (1) certain populations, including pregnant individuals and the medically frail, are exempt from the requirements and (2) states may provide an exception in a particular month for statutorily defined “short-term hardship events” including if an individual receives inpatient hospital services in that month.
CMS also provides clarity on a few technical issues. Specifically, the guidance contains additional details on when outreach to impacted individuals must occur and how individuals can demonstrate compliance with the requirement during the redetermination process.
While the WFTCL allows states to delay the effective date of the work requirements until December 31, 2028, CMS’ guidance indicates that exemptions “will be limited to states that are making meaningful efforts towards implementation and experience severe and/or unexpected issues that hinder their progress.”
If you have questions about how this guidance and the provisions of the WFTCL may impact you, please reach out to any Eyman Partners attorney to discuss.