Health Affairs January 12, 2026
Editor’s Note
This article is the latest in the Health Affairs Forefront featured topic, “Health Policy at a Crossroads,” produced with the support of the Commonwealth Fund and the Robert Wood Johnson Foundation. Articles in this topic offer timely analysis of regulatory, legislative, and judicial developments in health policy under the Trump-Vance Administration and the 119th Congress.
Under H.R.1, enacted last year, states must start requiring members of the Medicaid expansion group to demonstrate compliance with the new community engagement requirements by January 2027: to maintain coverage, nonexempt Medicaid enrollees in Affordable Care Act (ACA) expansion states must document 80 hours per month in activities including work, volunteer hours, or school. This is an extremely short implementation timeline, with important...
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