The 2025 budget reconciliation act (P.L. 119-21) directs state Medicaid agencies to implement work requirements — also referred to as community engagement requirements — for certain Medicaid enrollees by January 1, 2027. Under this policy, continued Medicaid eligibility will depend on participation in work or other qualifying activities. Engaging Medicaid members and other key stakeholders will be critical to designing processes — including verification, exemptions, and outreach — that are user-friendly, accessible, and aimed at minimizing unnecessary coverage loss. Input from members, community-based organizations (CBOs), and other community-based stakeholders can help states identify barriers, streamline administrative processes, and shape outreach strategies that support compliance and continuity of care. This engagement will help states translate federal requirements into clear, navigable policies that reduce the risk of avoidable disenrollment.

Project Description

Advancing Effective Work Requirements Implementation via Member Engagement and Outreach is an eight-month learning collaborative led by the Center for Health Care Strategies (CHCS) and made possible by the Commonwealth Fund. The initiative is supporting 12 states — Arizona, Idaho, Michigan, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, and Rhode Island — in developing effective approaches for engaging Medicaid members, CBOs, and other stakeholders throughout the design, implementation, and ongoing assessment of work requirements. CHCS will convene the states to create actionable strategies for elevating member perspectives — including through Beneficiary Advisory Councils (BACs) and other member engagement activities — with the goal of reducing complexity and promoting continuity of Medicaid coverage.

Throughout the project, participating states will have opportunities to share and learn promising approaches for engaging Medicaid members and other key stakeholders in the rollout of work requirements. States will be able to work through challenges alongside peers and experts throughout the project. Throughout the project, participating states will work together to strengthen their approaches to member and stakeholder engagement during the rollout of federal Medicaid work requirements. They will share lessons for engaging Medicaid members to inform work requirements design and implementation, build capacity to use established engagement approaches such as BACs, and explore strategies for partnering with community stakeholders on communications and outreach.

The project will also gather lessons from participating states and other states across the country to disseminate actionable tips and strategies for effectively engaging members and CBOs in the rollout and ongoing monitoring of work requirements.