What Medicaid’s Work Rules Mean for People Living with Mental Health and SUD

Last year, Congress passed federal legislation requiring individuals on Medicaid expansion to work, attend school, or volunteer for 80 hours per month to maintain coverage. On June 1, CMS issued implementation guidance 
with significant implications for both patients and providers pertaining to coverage continuity and eligibility verification. These changes introduce new compliance considerations that could impact access to care, particularly for individuals experiencing mental health and substance use challenges.

Several resources specific to MH and SUD are available:

• ASAM FAQ: Medicaid Community Engagement Requirements — What New Rules Mean for Patients with a Substance Use Disorder
• National Council: Detailed policy summary
• National Council practical FAQ for providers and stakeholders.