Montana has submitted an application to HHS to add work requirements and enhanced cost-sharing to its Medicaid expansion program.
Under the proposal, “working-age, able-bodied adults” with incomes up to 138% of the federal poverty level will be required to complete at least 80 hours per month of work or other qualifying activities, such as community service, workforce training or educational programs. Enrollees will have to verify compliance at least every six months.
The proposed 1115 Medicaid Demonstration waiver application was submitted to HHS Secretary Robert F. Kennedy Jr. on Sept. 2.
Under the recently signed One Big Beautiful Bill Act, states must establish Medicaid work requirements for certain individuals beginning in 2027, but the law allows states to implement the changes earlier.
According to the application, Montana law was amended in 2019 to require the state’s Department of Public Health and Human Services to implement community engagement requirements and premiums for the expansion population, but the changes were rejected by the Biden administration.
