CMS Work Rule Targets Expansion and Certain §1115 Adults; Texas's Main Medicaid Groups Are Outside Its Core Scope
CMS-2454-IFC requires 80 hours per month of work or qualifying activities beginning no later than January 1, 2027 for non-pregnant adults ages 19–64 who are enrolled in the ACA adult group or certain §1115 demonstrations that provide minimum essential coverage. Texas has not adopted the ACA adult expansion, so its ordinary parent, pregnancy, disability, and other categorical groups are not swept in simply because an enrollee is an adult.
Texas FQHCs should base workflows on any cohort HHSC specifically identifies, rather than treating every adult enrollee as subject.
Primary source
Centers for Medicare & Medicaid ServicesSource packet
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FQHC Talent. (2026, June 1). CMS Work Rule Targets Expansion and Certain §1115 Adults; Texas's Main Medicaid Groups Are Outside Its Core Scope. Primary source: Centers for Medicare & Medicaid Services. Retrieved July 21, 2026, from https://www.fqhctalent.com/intel/tx-medicaid-work-req-excepted-2026
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