MACPAC Discusses Recent Legislative Changes to Medicaid, Medicaid Work Requirements

The Medicaid and CHIP Payment and Access Commission (MACPAC) met on Sept. 18 and 19 to discuss topics including upcoming changes to Medicaid following the enactment of the One Big Beautiful Bill Act (OBBBA) (P.L. 119-21) with multiple sessions on Medicaid work requirements. Commissioners also reviewed and discussed background on behavioral health in Medicaid and the State Children's Health Insurance Program (CHIP) as well as the Medicare-Medicaid plan transition to integrated Medicare Advantage (MA) dual eligible special needs plans. The commission plans to continue monitoring the Medicare-Medicaid plan transition and share preliminary findings from their Transformed Medicaid Statistical Information System claims data analysis related to behavioral health utilization in future meetings.

Commissioners began their Thursday sessions with an overview of the Medicaid and the State CHIP provisions enacted with the passage of OBBBA, including those related to eligibility and enrollment, financing, services and payment, and the Rural Health Transformation Program. Following this, commissioners conducted a deeper dive into the newly enacted Medicaid work requirements, followed by a discussion panel of state-level experts on their experience with implementing these new requirements. Panelists discussed how they intend to operationalize work requirements mandated by the OBBBA, such as implementing necessary information technology systems, and discussed areas where additional federal guidance is necessary.