f. Individuals Compliant With TANF Work Requirements and Individuals Not Exempt From SNAP Work Requirements

Section 1902(xx)(9)(A)(ii)(VI) of the Act and implementing regulations at § 435.554(c)(6) and (7) describe categories of specified excluded individuals that reference existing work requirements in other jointly administered Federal-State programs. Specifically, clause (ii)(VI)(aa) references TANF and clause (ii)(VI)(bb) references SNAP. Section 1902(xx)(9)(A)(ii)(VI)(aa) of the Act and implementing regulations at § 435.554(c)(6) create an exclusion from the community engagement requirement for individuals who comply with the work requirements imposed by the State under section 407 of the Act as a condition of eligibility for TANF. Section 1902(xx)(9)(A)(ii)(VI)(bb) of the Act and the implementing regulations in § 435.554(c)(7) create an exclusion for an individual who is a member of a household that receives SNAP benefits and is not exempt from a work requirement under the Food and Nutrition Act of 2008.

As such, States must have a process to obtain information from the TANF agency and from the SNAP agency to determine whether an individual meets either of these criteria. If so, then the individual meets the definition of a specified excluded individual and therefore is not an applicable individual subject to the Medicaid community engagement requirement.

Our understanding is that many States already use TANF or SNAP (or both) agency systems as reliable sources of information available to the State for purposes of verifying other factors of eligibility or maintain shared eligibility systems with those programs. These States already have access to information to verify that an individual is a specified excluded individual under these categories based on the individual's most recent TANF work requirement compliance status or SNAP household eligibility and work requirement exemption and exception status. However, if the State does not yet have means to obtain these data from the TANF and the SNAP agency, the State must establish a process to obtain all the information needed from both programs to determine if an individual is a specified excluded individual under either of these categories to comply with the requirement at § 435.557(b)(1).

If there is no reliable information available to the State (for example, no information about the individual is returned from SNAP or TANF), or the reliable information is not reasonably ( printed page 33408) compatible with the information provided by or on behalf of the individual, the State must seek information from the individual to verify their specified excluded status. Beginning on January 1, 2028, when there is no reliable information available to the State or the reliable information is not reasonably compatible with the information provided by or on behalf of the individual, the State must require documentation if documentation is reasonably available. If there is no reasonably available documentation, the State must have a process to accept other information to verify eligibility, consistent with § 435.557(b)(2)(iii).