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Summary
Enacted July 4, 2025, the FY2025 budget reconciliation law (P.L. 119-21) included significant changes to the means-tested programs Medicaid and the Supplemental Nutrition Assistance Program (SNAP). The law created new Medicaid community engagement requirements for specified individuals (Section 71119) and expanded work requirements for SNAP (Section 10102). The Congressional Budget Office (CBO) estimated that the provision establishing the Medicaid community engagement requirements will reduce federal Medicaid outlays by $325.6 billion from FY2025 to FY2034, and the SNAP provision will reduce federal SNAP outlays by $69 billion over the same 10-year period. Policymakers may be interested in how the enacted policies compare and contrast as states and households face changes in both programs.
P.L. 119-21 establishes a new community engagement requirement as a condition of Medicaid eligibility or continued enrollment for specified individuals who are eligible for (or enrolled under) the Affordable Care Act (ACA) Medicaid expansion pathway or who are eligible for (or enrolled under) a waiver that provides minimum essential health coverage. This group is technically known as “applicable individuals.” Prior to the enactment of P.L. 119-21, there was no statutory requirement for Medicaid enrollees comparable to the new community engagement requirement, although the new statutory provision builds on the first Trump Administration’s Medicaid Section 1115 demonstration waiver initiative that allowed states to implement Medicaid community engagement requirements.
P.L. 119-21 built on an existing SNAP requirement for Able-Bodied Adults Without Dependents (ABAWDs). The ABAWD rule was enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193). P.L. 119-21 both expands the population subject to the ABAWD rule and shrinks available waivers and exemptions.