📢 New Medicaid Community Engagement Requirement: What Advocates Should Know for 2027

How many times have you supported a patient or caregiver who was overwhelmed by medical bills, losing coverage, unable to afford care, or facing serious health needs during financial hardship?

For many of these clients, Medicaid may be an important step to access care and reduce financial stress.

However, important Medicaid changes are expected to begin in January 2027. As advocates, we need to understand them so we can help patients and families prepare, ask the right questions, and avoid losing coverage due to confusion, missed notices, or missed deadlines.

🔎 What is changing?

Some adults may need to complete at least 80 hours per month of qualifying activities such as work, school, job training, work programs, community service, or a combination of these activities to apply for or keep Medicaid coverage.

👥 Who may be affected?

Some adults between 19 and 64 years old, depending on their Medicaid coverage type and whether an exemption applies.

✅ Who may not subject to this requirement?

This requirement does not apply to every Medicaid member. For example, adults 65 or older, Medicare beneficiaries, pregnant or postpartum individuals, people who are medically frail, certain caregivers, and other protected groups may not be subject to the requirement.

📍Will the process be the same in every state?

Not completely. The requirement comes from federal law, but each state will create its own process for reporting activities, required documents, deadlines, hardship exceptions, and appeal rights.

📝 How can advocates prepare?

Patient and healthcare advocates can begin preparing now by focusing on the areas that may create the most confusion for clients:

• Follow official CMS, Medicaid.gov, and state Medicaid updates since some details may still change.

• Learn who may be affected and who may be exempt to ask better questions and avoid assumptions that a client is automatically affected or exempt.

• Encourage clients to keep their Medicaid contact information updated, such as mailing address, phone, and email, so clients receive important notices on time and do not miss important deadlines.

• Remind clients to read Medicaid notices carefully and respond on time to avoid misunderstandings that could place their coverage at risk.

• Help clients save and organize important documentation to assess any possible exemption.

• Review appeal rights if coverage is denied, terminated, or at risk to submit any appeal or missing information on time.

💙 The goal is not to create fear or confusion.

The goal is to stay informed, follow official updates, and help patients and families understand their options before coverage is at risk.

Because this process is still developing, I’ll continue sharing updates as more official guidance becomes available.