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DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services

7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 CMCS Informational Bulletin DATE: November 18, 2025 FROM: Dan Brillman Deputy Administrator, CMS Director, Center for Medicaid and CHIP Services (CMCS) SUBJECT: “Working Families Tax Cut” Legislation, Public Law 119-21: Summary of Medicaid and Children's Health Insurance Program (CHIP) Related Provisions Introduction On July 4, 2025, President Trump signed Public Law 119-21, also known as the “One Big Beautiful Bill Act,” which the Centers for Medicare & Medicaid Services (CMS) refers to as the “Working Families Tax Cut” (WFTC) legislation, into law. This landmark legislation includes significant eligibility and financing reforms in Medicaid and the Children’s Health Insurance Program (CHIP) and focuses on the connection of health to work through community engagement. Specific eligibility reforms aim to ensure lawful enrollment in Medicaid and CHIP. The financing reforms in the law focus on ensuring that states contribute their full commitments to finance Medicaid and reducing financing loopholes. Community engagement requirements have the potential to empower Medicaid beneficiaries through employment, education, or volunteer service so they can escape isolation, build confidence, and achieve prosperity. These provisions reflect a commitment to safeguarding Medicaid and CHIP for the most vulnerable Americans now and in the future. These reforms also impact program operations, enhance oversight capabilities, and establish new accountability measures for Medicaid and CHIP. Taken together with other CMS priorities, the reforms lay the groundwork for a stronger state-federal partnership that improves health outcomes among beneficiaries. This CMCS Informational Bulletin (CIB) provides general information to states, stakeholders, and others on the Medicaid and CHIP provisions contained in the WFTC legislation. This CIB represents part of a series of guidance documents that CMCS expects to issue to support the implementation of the WFTC legislation provisions. CMCS expects to provide additional detailed guidance in the coming months addressing specific provisions and implementation requirements. We also plan to undertake rulemaking as required under the law or as otherwise warranted. CMCS is committed to supporting successful implementation of these transformative